容积移位技术在早期乳腺癌保乳术中的应用

Application of volumet - displacement technique following breast conserving surgery in early breast cancer

目的：探讨容积移位技术在早期乳腺癌保乳术中的应用并评估其美学价值。方法选择早期乳癌行保乳手术患者77例，其中42例采用容积移位技术整形保乳（保乳组），35例采用不缝合腺体仅缝合皮肤传统保乳术（常规组），术后及放疗后1个月分别评价两组患者的乳房美学效果。结果77例患者随访1～36个月，中位随访时间22．3个月，无1例复发及转移。术后1个月，乳房外形上达到优良，整形组与常规组分别为31例（73．81％）和17例（48．57％），差异有统计学意义（χ2＝5．442，P ＝0．021）；放疗后1个月，两组达到优良效果的分别为27例（64．29％）和6例（17．14％），差异有统计学意义（χ2＝9．045，P ＝0．008）。结论容积移位技术可以提高早期乳癌保乳术的乳房美学效果且不影响疗效，值得推广。

Objective To explore the application and assess the cosmetic effect of mammaplasty with volume - displacement technique（VDT） following breast conserving surgery. Methods Breast conservation therapy（BCT） was performed in 77 patients of early breast cancer（EBC）. Of the patients ,42 eases received oncoplastic VDT （ onco- plastic group） and 35 cases had only direct skin closure without treatment of the postreseetion defect （regular group） following BCT. The cosmetic results of the two groups were evaluated after operation and radiotherapy, respectively. Results All patients were followed up for 1 - 36 months with median follow - up of 22.3 months, and no recurrence or metastasis occurred in one of the patients. 1 month after surgery, the excellent or good cosmetic outcome were achieved in 31 cases （73.81%） in oncoplastic group and 17 cases （48.57%） in regular group respectively, and there was statistical difference between the two groups （X2 = 5. 442,P = 0. 021 ） ;1 month after radiotherapy,the cos- metic excellent or good result were obtained in 27 cases （64.29%） in oncoplastic group and 6 cases （ 17, 14% ） in regular group respectively, and the difference between the two groups reached statistical significance （X2 = 9.045, P = 0, 008）. Conclusion VDT can improve the cosmetic effect of mammaplasty following BCT in EBC and does not affect curative effect, it is worthy of promoting.