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中华乳腺病杂志(电子版) ›› 2016, Vol. 10 ›› Issue (04) : 243 -246. doi: 10.3877/cma.j.issn.1674-0807.2016.04.011

综述

保留乳头乳晕乳房切除-重建术研究进展
夏想厚1, 俞洋1,(), 杨红健1   
  1. 1.310022 杭州,浙江省肿瘤医院乳腺外科
  • 收稿日期:2016-03-09 出版日期:2016-08-01
  • 通信作者: 俞洋

Nipple-areola conserving mastectomy and breast reconstruction

Xianghou Xia, Yang Yu(), Hongjian Yang   

  • Received:2016-03-09 Published:2016-08-01
  • Corresponding author: Yang Yu
引用本文:

夏想厚, 俞洋, 杨红健. 保留乳头乳晕乳房切除-重建术研究进展[J/OL]. 中华乳腺病杂志(电子版), 2016, 10(04): 243-246.

Xianghou Xia, Yang Yu, Hongjian Yang. Nipple-areola conserving mastectomy and breast reconstruction[J/OL]. Chinese Journal of Breast Disease(Electronic Edition), 2016, 10(04): 243-246.

保留乳头乳晕乳房切除-重建术是近年来乳腺癌外科治疗的新方向和热点问题。 相比于传统改良根治术,保留乳头乳晕乳房切除-重建术保留乳腺癌患者形体上完整,弥补了患者乳房缺失的心理缺失。 然而保留乳头乳晕乳房切除-重建术在乳腺癌外科治疗上的安全性一直广受争议,手术适应证也未完全明确,手术切口选择、切缘处理及重建方式选择失当导致的乳头坏死等问题也亟须进一步探讨。 笔者将从以上几个角度探讨一下保留乳头乳晕乳房切除-重建术研究的最新进展。

图1 保留乳头乳晕乳房切除-重建术的切口设计示意图 注:图a 表示沿乳晕弧形-侧方延伸切口;图b 表示沿乳头弧形-侧方延伸切口;图c 表示横跨乳头乳晕-侧方延伸切口;图d 表示沿乳房皱褶切口;图e 表示放射状S 形切口;图f 表示放射状直形切口
[1]
Didier F, Radice D, Gandini S, et al. Does nipple preservation in mastectomy improve satisfaction with cosmetic results, psychological adjustment, body image and sexuality? [J]. Breast Cancer Res Treat,2009,118(3):623-633.
[2]
Momoh AO, Colakoglu S, de Blacam C, et al. The impact of nipple reconstruction on patient satisfaction in breast reconstruction[J]. Ann Plast Surg,2012,69(4):389-393.
[3]
Stanec Z, Žic R, Budi S, et al. Skin and nipple-areola complex sparing mastectomy in breast cancer patients: 15-year experience[J].Ann Plast Surg,2014,73(5):485-491.
[4]
De La Cruz L,Moody AM,Tappy EE,et al. Overall survival,diseasefree survival, local recurrence, and nipple-areolar recurrence in the setting of nipple-sparing mastectomy: a meta-analysis and systematic review[J]. Ann Surg Oncol,2015,22(10):3241-3249.
[5]
Stolier AJ, Wang J. Terminal duct lobular units are scarce in the nipple: implications for prophylactic nipple-sparing mastectomy:terminal duct lobular units in the nipple[J]. Ann Surg Oncol,2008,15(2):438-442.
[6]
Gerber B,Krause A,Dieterich M,et al. The oncological safety of skin sparing mastectomy with conservation of the nipple-areola complex and autologous reconstruction: an extended follow-up study[J]. Ann Surg,2009,249(3):461-468.
[7]
Sakurai T, Zhang N, Suzuma T, et al. Long-term follow-up of nipplesparing mastectomy without radiotherapy: a single center study at a Japanese institution[J]. Med Oncol,2013,30(1):481.
[8]
de Alcantara FP, Capko D, Barry JM, et al. Nipple-sparing mastectomy for breast cancer and risk-reducing surgery: the Memorial Sloan-Kettering Cancer Center experience[J]. Ann Surg Oncol,2011,18(11):3117-3122.
[9]
Freeman BS. Subcutaneous mastectomy for benign breast lesions with immediate or delayed prosthetic replacement[J]. Plast Reconstr Surg Transplant Bull,1962,30:676-682.
[10]
马榕,孙靖中,王建丽,等.乳腺癌乳头和乳晕部浸润[J]. 中华外科杂志,1996,34(3):61-64.
[11]
Petit JY, Veronesi U, Orecchia R, et al. Nipple sparing mastectomy with nipple areola intra operative radiotherapy: one thousand and one cases of a five years experience at the European institute of oncology of Milan (EIO)[J]. Breast Cancer Res Treat,2009,117(2):333-338.
[12]
Coopey SB, Tang R, Lei L, et al. Increasing eligibility for nipplesparing mastectomy[J]. Ann Surg Oncol,2013,20(10):3218-3222.
[13]
Huang NS,Wu J. Nipple-sparing mastectomy in breast cancer:from an oncologic safety perspective[J]. Chin Med J (Engl),2015,128(16):2256-2261.
[14]
Brachtel EF, Rusby JE, Michaelson JS, et al. Occult nipple involvement in breast cancer: clinicopathologic findings in 316 consecutive mastectomy specimens[J]. J Clin Oncol,2009,27(30):4948-4954.
[15]
Billar JA, Dueck AC, Gray RJ, et al. Preoperative predictors of nipple-areola complex involvement for patients undergoing mastectomy for breast cancer[J]. Ann Surg Oncol,2011,18(11):3123-3128.
[16]
Chirappapha P, Petit JY, Rietjens M, et al. Nipple sparing mastectomy: does breast morphological factor related to necrotic complications? [J]. Plast Reconstr Surg Glob Open,2014,2(1):e99.
[17]
Rossi C, Mingozzi M, Curcio A, et al. Nipple areola complex sparing mastectomy[J]. Gland Surg,2015,4(6):528-540.
[18]
Komorowski AL, Zanini V, Regolo L, et al. Necrotic complications after nipple- and areola-sparing mastectomy[J]. World J Surg,2006,30(8):1410-1413.
[19]
Davies K, Allan L, Roblin P, et al. Factors affecting post-operative complications following skin sparing mastectomy with immediate breast reconstruction[J]. Breast,2011,20(1):21-25.
[20]
Janssen S, Holz-Sapra E, Rades D, et al. Nipple-sparing mastectomy in breast cancer patients: the role of adjuvant radiotherapy (review)[J]. Oncol Lett,2015,9(6):2435-2441.
[21]
Algaithy ZK, Petit JY, Lohsiriwat V, et al. Nipple sparing mastectomy: can we predict the factors predisposing to necrosis? [J].Eur J Surg Oncol,2012,38(2):125-129.
[22]
蔡英,张亚男.保留乳头乳晕复合体乳房切除术后复合体坏死的研究[J/CD]. 中华乳腺病杂志:电子版,2014,8(5):361-364.
[23]
Rusby JE, Brachtel EF, Taghian A, et al. George Peters Award.Microscopic anatomy within the nipple: implications for nipple-sparing mastectomy[J]. Am J Surg,2007,194(4):433-437.
[24]
Rawlani V, Fiuk J, Johnson SA,et al. The effect of incision choice on outcomes of nipple-sparing mastectomy reconstruction[J]. Can J Plast Surg,2011,19(4):129-133.
[25]
Amanti C, Vitale V, Lombardi A, et al. Importance of perforating vessels in nipple-sparing mastectomy: an anatomical description[J].Breast Cancer (Dove Med Press),2015,7:179-181.
[26]
Schneider LF, Chen CM, Stolier AJ, et al. Nipple-sparing mastectomy and immediate free-flap reconstruction in the large ptotic breast[J].Ann Plast Surg,2012,69(4):425-428.
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