乳腺癌改良根治术后自体背阔肌皮瓣乳房重建术后X线表现

X-ray manifestations of reconstructed breast using autologous latissimus dorsi musculocutaneous flap after modified radical mastectomy for breast cancer

目的:探讨乳腺癌改良根治术及自体背阔肌皮瓣乳房重建术后X线表现。方法:46例行乳腺癌改良根治术及自体背阔肌皮瓣乳房重建术的患者,术后使用GE Senographe DS全数字化乳腺摄影机进行检查。结果:46例中于重建术后第一年内进行X线检查者12例,主要表现为背阔肌影约占乳房一半者9例,小于一半者2例,大于一半者仅1例;重建术后第二年内进行X线检查者21例,表现为背阔肌影约占乳房一半者有2例,小于一半者18例,大于一半者1例;重建术后第三年内进行X线检查者13例,均表现为背阔肌影明显小于乳房的一半。乳房重建术后其它表现:出现钙化影3例,小结节影2例。结论:乳腺癌根治术及自体背阔肌皮瓣乳房重建术后,随着时间延长而表现为背阔肌逐渐萎缩、局部脂肪逐渐增多。

Objective：To investigate the X-ray manifestations of reconstructed breast using autologous latissimus dorsi musculocutaneous flap after modified radical mastectomy for breast cancer.Methods：Modified radical mastectomy and breast reconstruction using autologous latissimus dorsi musculocutaneous flap were performed in 46 breast cancer patients who had strong demand for better life quality after operation.All patients were examined by full digital mammography （FFDM）system （GE Senographe DS）.Results：Among 12 （12/46）patients undergone X-ray examination in the first year after breast reconstruction,latissimus dorsi shadow accounting for about half of the breast was found in 9 cases,less than half of the breast in 2 cases and larger than half of the breast in 1 case;in the second year after breast reconstruction,21 pa-tients underwent X-ray examination,including 2 cases with latissimus dorsi shadow accounting for about half of the breast, 18 cases less than half of the breast and 1 case larger than half of the breast;in the third year,13 patients underwent X-ray examination and all showed that latissimus dorsi shadow accounted for about half of the breast.The other findings after op-eration：local calcification in 3 cases and nodule in 2 cases.Conclusion：The main changes of reconstructed breast may be gradual shrinkage of latissimus dorsi and increase of fat over time after breast reconstruction using autologous latissimus dorsi musculocutaneous flap in patients after modified radical mastectomy for breast cancer.