目的

探讨巨大局部晚期乳腺癌的手术治疗和修复方法。

方法

回顾本科2006年3月至2009年5月收治的8例巨大局部晚期乳腺癌患者,其中6例为原发肿瘤,2例为复发肿瘤,对其手术和修复方法进行分析。

结果

本组8例患者的胸壁软组织缺损均选用皮瓣及肌皮瓣修复,其中3例行全层胸壁切除,均用钛网修复骨性缺损。本组患者术后皮瓣均存活良好,无重大并发症,无围手术期死亡。3例全层胸壁重建患者术后呼吸功能正常,未出现反常呼吸。

结论

大部分巨大晚期乳腺癌的患者可以手术治疗,创面修复是其重要组成部分,往往需要包括整形外科在内的多学科协作治疗,以改善患者的生存质量,创造综合治疗的条件。

Objective

To explore the surgery and repair of giant locally advanced breast cancer.

Methods

Eight patients with giant locally advanced breast cancer in our department from 2006 to 2009 were reviewed retrospectively,including 6 patients with primary tumor and 2 patients with recurrent tumor.The analysis focused on the surgery and repair methods.

Results

Three patients underwent full thickness chest wall resection and chest wall defects were repaired with titanium plates.The soft tissue defects of the 8 patients were repaired with flaps and myocutaneous flaps.No severe complications or deaths occurred after surgery.All flaps survived well.The three patients who underwent full thickness chest wall repair maintained normal post-operative respiratory function with no paradoxical breathing observed.

Conclusions

Surgery is a viable treatment option for most patients with giant locally advanced breast cancer.Defects repair is one of the most important procedures and frequently need multi-disciplinary collaborations between departments including the department of plastic and reconstructive surgery,which can improve patients'survival and elevate the conditions of multi-therapies.