部分乳晕乳头再造术在伴有血性乳头溢液乳腺癌患者中的应用

Partial reconstruction of areola-nipple-complex for breast cancer patients with bloody nipple discharge

目的探讨在伴有血性乳头溢液的乳腺癌患者中应用部分乳晕乳头再造术的可行性和安全性。方法本回顾性研究纳入2015年10月至2017年12月在大连医科大学附属第二医院行部分乳晕乳头再造术的5例伴有血性乳头溢液的乳腺癌患者,评估患者的术后并发症、乳头对称性、乳头回缩率、满意度以及复发、转移情况。结果共再造5个乳头,术后乳头均存活,伤口愈合良好。术后中位随访39个月(范围:20~46个月),5例患者中3例非常满意,2例满意。5例患者均未发生肿瘤局部复发或远处转移,再造乳头虽存在一定程度缩小(范围:13.1%~48.1%,平均乳头回缩率为38.5%),但与健侧乳头形态比较,对称性较好。结论部分乳晕乳头再造术在符合标准的伴有血性乳头溢液的乳腺癌患者中,是一种安全可行、简单微创的乳头再造术式。

Objective To explore the feasibility and safety of partial reconstruction of areola-nipple-complex for breast cancer patients with bloody nipple discharge.Methods This retrospective study included five breast cancer patients with bloody nipple discharge who underwent partial reconstruction of areola-nipple-complex in the Second Affiliated Hospital of Dalian Medical University from October 2015 to December 2017.After operation,postoperative complications,asymmetry of both nipples,nipple retraction rate,patient satisfaction,recurrence and metastasis were comprehensively evaluated.Results All 5 reconstructed nipples survived and healed well after operation.The patients were followed up for 20-46 months,median 39 months.There were 3 patients showed high-level satisfaction with the surgery and 2 showed moderate.There was no local recurrence or distant metastasis in 5 cases.Although the reconstructed nipples had shrunk to a certain extent(range:13.1%-48.1%,the average nipple retraction rate was 38.5%),they presented good asymmetry with contralateral nipples.Conclusion In eligible breast cancer patients with bloody nipple discharge,partial reconstruction of areola-nipple-complex was safe,feasible and minimally invasive.