摘要
即刻乳房重建在避免病人接受二次手术的同时,可以减轻病人失去乳房的心理创伤。但是,肿瘤外科医生在选择即刻乳房重建时必须保证肿瘤的安全性,术前细致的评估、术中足够完整的腺体切除是保证肿瘤安全性的前提。美国国家综合癌症网络(NCCN)指南明确指出,炎性乳腺癌是即刻乳房重建的禁忌证,此外,对于拟行术后放疗的病人也需慎重选择即刻乳房重建;尽管缺乏高级别循证医学证据,但现有的数据显示,即刻乳房重建并不影响术后辅助化疗的疗效,部分病人选择保留乳头乳晕的皮下腺体切除是安全可靠的,假体植入术后的淋巴瘤虽有报道,但发病率很低。因此,乳房切除术后即刻乳房重建在适宜的乳腺癌病人中是安全可靠的手术方式。
Immediate breast reconstruction can reduce the psychological trauma of breast loss while preventing patients from undergoing secondary surgery.However,oncologists must ensure tumor safety when choosing immediate breast reconstruction.Careful preoperative evaluation and adequate intraoperative glandectomy are the prerequisites to ensure oncologic safety.The National Comprehensive Cancer Network(NCCN)guidelines clearly states that inflammatory breast cancer is a contraindication to immediate breast reconstruction.In addition,for patients who plan to receive postoperative radiotherapy,immediate breast reconstruction should be carefully selected.Despite the lack of high-level evidence-based evidence,available data show that immediate breast reconstruction does not affect postoperative adjuvant chemotherapy.It is safe and reliable for some patients to choose the subcutaneous gland resection that retains nipples and areola.Lymphoma after prosthesis implantation has been reported,but the incidence is low.Therefore,breast reconstruction immediately after mastectomy is a safe and reliable surgical procedure in suitable patients with breast cancer.
作者
王殊
王朝斌
WANG Shu;WANG Chao-bin(Breast Center of Peking University People's Hospital,Beijing 100044,China)
出处
《中国实用外科杂志》
CSCD
北大核心
2019年第11期1168-1172,共5页
Chinese Journal of Practical Surgery
关键词
即刻乳房重建
放疗
化疗
乳头乳晕复合体
immediate breast reconstruction
radiotherapy
chemotherapy
nipple–areola complex
作者简介
通信作者:王殊,E-mail:wangshu@pkuph.edu.cn
