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Two modified Surgical Procedures for Treating Early Stage Breast Cancer in China

Journal of Huazhong University of Science and Technology(Medical Sciences) 2014年第6期34卷 917-920页

作者：邓裴吴乐昊任玉萍吴毅平 Department of Plastic and Reconstructive Surgery Tongji Hospital Tongji Medical College Huazhong University of Science and Technology

Conventional pedicled-flap based surgeries in treating breast cancer have their limitations. New surgical regimens are yet to be explored, which will follow the oncological principle of being “to- tal tumor free”, whilst fit into the unique characteristics of China＇s own medical system as well as pa- tients＇ demand. From 2007 to 2013, 143 patients with early stage breast cancer were included in the study, with the average age of 46.1 years. Fifty-three patients were subjected to modified breast con- serving surgery （MBCS）＋latissimus dorsi （LD） flap reconstruction, 41 to skin sparing mastectomy （SSM）＋implant＋LD flap reconstruction, 29 to MBCS＋distal transverse rectus abdominis myocutaneous （DTRAM） flap reconstruction, and 20 to SSM＋DTRAM flap reconstruction. The results showed that out of the 143 patients, there was no graft loss. Minor complications included 4 cases of fat liquefaction, and 6 cases of seratoma, which all resolved after conservative treatment. Five patients had visible protu- berance in the abdomen, but not leading to any gastrointestinal symptoms. The reconstructed breasts all presented good shape. 96.7% of the patients were satisfied with the outcome. The follow-up period var- ied from 6 months to 60 months, and only one patient died from tumor metastasis in the brain. No local recurrence occurred. It was concluded that these two modified pedicled-flap surgeries are readily practi- cal, and aesthetically satisfactory, with high applicability in China. They do not compromise the on- cological outcomes, but also are well-accepted by Chinese patients.

关键词： early breast cancer breast conserving surgery modified transverse rectus abdominismyocutaneous flap reconstruction

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