早期乳腺癌环乳晕切口行保乳术

Breast conserving surgery by using " surround-mammary areola incision" for early breast cancer

环乳晕切口设计,在乳晕与皮肤交界处环乳晕行360°标记切口;乳晕区核素注射。手术步骤:1体位准备,标记好环乳晕切口,体表前哨定位,术野消毒,染料示踪。2环乳晕切口保乳术,沿乳晕环形切开皮肤、皮下脂肪浅层,观察前哨淋巴通道(SLCs)走向,扩大完整切除肿瘤,标记送病检,如切缘阴性,放置钛夹,可适当游离周围腺体,端端缝合,预防皮下空腔,如二次切缘阳性则行全切±整形。3联合法行前哨淋巴结活检术,沿前哨淋巴结(SLNs)体表定位处作腋窝顺皮纹切口,找到SLCs,顺藤摸瓜找到SLNs,标顺序后送病检,规范处理。

A surround-mammary areolar incision or a 360° circular incision around the areola was made with injection of nuclide under the areola area skin. The incision includes the following steps：1. Preparation of operation position,incision marked around the areola,lymph node localized on skin,disinfection of operative field and injection of nuclide under the areola area. 2. Breast conserving surgery associated with surround-mammary areola incision. We cut skin and subcutaneous fat via the surround-mammary areola incision,observed the direction of SLCs,and completely removed the breast tumor marked for pathological examination. If the incised margin was free of tumor,we put titanium clamps into incision,kept the surrounding tissue free,sutured the subcutaneous tissue to prevent subcutaneous cavity. If the tumor located at the incised margin,mastectomy and breast reconstruction should be done. Sentinel lymph node biopsy was carried out to cut skin from SLNs under the axillary area,find SLCs and SLNs,and then indicate the sequence of SLCs for pathological examination.