不同分期乳腺癌术后即刻乳房重建的新思考

Inspirations on immediate breast reconstruction after mastectomy for breast cancer in different stages

乳腺癌作为女性最常见的恶性肿瘤,在全球范围内仍是一个重大公共卫生问题。随着患者对生活质量要求的提高与生存率的提升,越来越多的患者倾向于选择乳腺癌术后即刻乳房重建(immediate breast reconstruction,IBR),有利于改善患者的心理健康和生活质量,也加快了重建技术的不断创新。然而国内外对不同分期乳腺癌术后重建的方案选择仍有诸多争议,不同分期的乳腺癌在肿瘤大小、治疗方案、并发症风险、患者诉求及认知程度等均有较大差异,故乳房重建类型的选择也需兼顾肿瘤学安全性和美观要求等多个方面。本文根据中国医学科学院肿瘤医院的临床经验并综合国内外文献,分析IBR的特点,探讨IBR在不同分期乳腺癌治疗方案中的作用,为乳腺癌的综合治疗提供参考。

Breast cancer,as the most frequently diagnosed malignancy in women,remains a worldwide public health dilemma.With the improvement of patients’quality of life and survival rate,the increasing number of patients tend to choose immediate breast reconstruction(IBR)after mastectomy for breast cancer,which is conducive to improving patients'mental health and life qualities.It has also accelerated the continuous innovation of breast reconstruction technology.However,there are still many controversies globally regarding the choice of postmastectomy reconstruction for different stages of breast cancer.Different stages of breast cancer have big variability in tumor volume,treatment plans,risk of complications,patient demands and cognitive condition.Therefore,multiple aspects such as oncology safety and aesthetic requirements of patients should be taken into consideration by surgeons.Based on clinical experience of Cancer Hospital Chinese Academy of Medical Sciences and domestic and foreign literature,this article aims to analyze the characteristics of immediate breast reconstruction,explores the role of IBR in different stages of breast cancer treatment,and to provide a reference for the comprehensive treatment of breast cancer.