背阔肌肌皮瓣修复新辅助化疗后局部晚期乳腺癌组织缺损的疗效观察

The latissimus dorsi muscle flap reconstructed with after neoadjuvant chemotherapy for locally advanced breast cancer

目的：探讨我科12例局部晚期伴有皮肤侵犯导致溃疡形成的乳腺癌患者，术前行新辅助化疗后行改良根治术，即刻应用背阔肌肌皮瓣即时修复组织缺损的疗效观察。方法：12例患者均于术前行4～6周期新辅助化疗TEC方案，后达到临床部分缓解（PR）、创面缩小后，行乳腺癌改良根治术、即刻背阔肌肌皮瓣转移修复胸壁组织缺损。结果：12例患者手术均成功，接受新辅助化疗和术后放疗。随访10～24个月，术后远处转移1例，无局部复发和死亡病例。结论：局部晚期乳腺癌新辅助化疗后，应用背阔肌肌皮瓣转移至胸壁修复组织缺损切实可行。

Objective To study the therapeutic effects on using latissimus dorsi muscle flap reconstructed after neoadjuvant chemotherapy for locally advanced invasive breast cancer. Methods 12 locally advanced invasive breast cancer patients were followed neoadjuvant chemotherapy regimens TEC 4-6 cycles,and got clinical partial remission （PR）.Then all patients were reconstructed with latissimus dorsi muscle flap. Results All patients obtained successful reconstructive surgical procedures.12 patients were received neoadjuvant chemotherapy and received adjuvant radiation therapy.All the patients were followed-up for 10-24 months （mean 16 months）, having found that all the patients survived.None patient had local recurrence and 1 case had lung metastasis.Conclusion Latissimus dorsi muscle flap operation can be performed in locally advanced invasive breast cancer after neoadjuvant chemotherapy and it should not influence adjuvant therapy and long-term therapeutic effect.