Treatment Experience about The Skin-Sparing Mastectomy and Immediate Breast Reconstruction of 10 Cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

GAO Haiyan , ZHU Yulan , LIN Weijia

Department of General Surgery， The Second Affiliated Hospital of Changzhou， Nanjing Medical University， Changzhou 213000， Jiangsu Province， China;

Corresponding author：

Keywords：

Breast reconstruction; Transverse rectus abdominis myocutaneous; Breast cancer

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Objective 　To introduce the treatment experiences about the skin-sparing mastectomy and immediate breast reconstruction.
Methods 　The skin-sparing mastectomy and immediate breast reconstruction by using transverse rectus abdominis myocutaneous （TRAM） flat were performed in 10 patients with early-stage breast cancer from May 2008 to December 2011 in our hospital. The patients’ data were retrospectively analyzed.
Results 　There were postoperative complications after skin-sparing mastectomy and immediate breast reconstruction， including TRAM flat necrosis in 1 case， papillary necrosis in 1 case and fat necrosis in the reconstructed breast with oxter wound infection in 1 case. There was no incision hernia of abdominal wall or necrosis of all TRAM flat in any case. The patients’ satisfaction that evaluation for the breast shapes of reconstructed breasts was very satisfaction in 5 cases， part satisfaction in 4 cases， and dissatisfaction in 1 case， respectively.
Conclusions 　Because of the minimal access approach and good breast shape， the skin-sparing mastectomy and immediate TRAM flat breast reconstruction is a safe and effective way for treating early-stage breast cancer.

Citation： GAO Haiyan,ZHU Yulan,LIN Weijia. Treatment Experience about The Skin-Sparing Mastectomy and Immediate Breast Reconstruction of 10 Cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(9): 962-966. doi: Copy

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2.	Gui GP， Kadayaprath G， Tan SM， et al. Evaluation of outcome after immediate breast reconstruction：prospective comparison of four methods[J]. Plast Reconstr Surg， 2005， 115(7)：1916-1926.
3.	Ziswiler-Gietz J， Makrodimou M， Harder Y， et al. Outcome analysis of breast reconstruction with free transverse rectus abdominis musculocutaneous (TRAM) flaps[J]. Swiss Med Wkly， 2008， 138(7-8)：114-120.
4.	张学慧，尹健，张如明，等. 女性乳腺癌保留胸大肌术后Ⅰ期乳房再造[J]. 中国肿瘤临床， 2002， 29(7)：495-497.
5.	Chun YS， Sinha I， Turko A， et al. Outcomes and patient satisfaction following breast reconstruction with bilateral pedicled TRAM flaps in 105 consecutive patients[J]. Plast Reconstr Surg， 2010， 125(1)：1-9.
6.	Jemal A， Siegel R， Ward E， et al. Cancer statistics， 2006[J]. CA Cancer J Clin， 2006， 56(2)：106-130.
7.	Kronowitz SJ， Hunt KK， Kuerer HM， et al. Delayed-immediate breast reconstruction[J]. Plast Reconstr Surg， 2004， 113 (6)：1617-1628.
8.	宣立学，穆兰花，张保宁. 整形外科技术在乳腺癌治疗中的应用[J]. 中国实用外科杂志， 2006， 26(4)：306-308.
9.	Chagpar A， Langstein HN， Kronowitz SJ， et al. Treatment and outcome of patients with chest wall recurrence after mastectomy and breast reconstruction[J]. Am J Surg， 2004， 187(2)：164-169.
10.	Sandelin K， Wickman M， Billgren AM. Oncological outcome after immediate breast reconstruction for invasive breast cancer：a long-term study[J]. Breast， 2004， 13(3)：210-218.
11.	Cunnick GH， Mokbel K. Skin-sparing mastectomy[J]. Am J Surg， 2004， 188(1)：78-84.
12.	黄晓辉，陈凛，石怀银. 早期乳腺癌保留皮肤的保乳手术安全性研究[J]. 解放军医学杂志， 2007， 32(3)：258-259.
13.	Ho CM， Mak CK， Lau Y， et al. Skin involvement in invasive breast carcinoma：safety of skin-sparing mastectomy[J]. Ann Surg Oncol， 2003， 10(2)：102-107.
14.	Toth BA， Forley BG， Calabria R. Retrospective study of the skin-sparing mastectomy in breast reconstruction[J]. PlastReconstr Surg， 1999， 104(1)：77-84.
15.	Kissin MW， Kark AE. Nipple preservation during mastectomy[J]. Br J Surg， 1987， 74(1)：58-61.
16.	曾健，陆云飞，林进令. 保留皮肤或保留乳头、乳晕的乳腺癌改良根治术后扩展型背阔肌肌皮瓣即时乳房再造[J]. 中国综合临床， 2005， 21(10)：897-899.
17.	王圣应，鲁智，程新德，等. 早期乳腺癌保留乳头乳晕的复合体的改良根治术——Ⅰ期腹直肌肌皮瓣重建乳房[J]. 癌症， 2004， 23(1)：56-59.
18.	高德宗，孙靖中，尹群生，等. 女性乳房手术预防乳头乳晕坏死的血供研究[J]. 中国普通外科杂志， 2005， 14(4)：269-272.
19.	Slavin SA， Schnitt SJ， Duda RB， et al. Skin-sparing mastectomy and immediate reconstruction：oncologic risks and aesthetic results in patients with early-stage breast cancer[J]. PlastReconstr Surg， 1998， 102(1)：49-62.
20.	Soong IS， Yau TK， Ho CM， et al. Post-mastectomy radiotherapy after immediate autologous breast reconstruction in primary treatment of breast cancers[J]. Clin Oncol， 2004， 16(4)：283-289.
21.	王仲照. 即刻乳房再造在乳腺癌治疗中的应用[J]. 癌症进展， 2005， 3(2)：144-150.
22.	薛秀丽，邱志丽，邹小明. 乳腺癌改良根治术后Ⅱ期应用腹直肌皮瓣重建乳房再造1例[J]. 哈尔滨医科大学学报， 2007， 41(5)：516-517.
23.	张立成. 乳腺癌术后乳房再造的进展[J]. 实用全科医学， 2007， 5(11)：1010-1011.
24.	汤学良，邹天宁，陈德滇，等. 乳腺癌改良根治术后自体肌皮瓣乳房重建21例[J]. 肿瘤学杂志， 2002， 8(6)：354．.
25.	Mizgala CL， Hartrampf CR Jr， Bennett GK. Assessment of the abdominal wall after pedicled TRAM flap surgery：5- to 7-year follow-up of 150 consecutive patients[J]. Plast Reconstr Surg， 1994， 93(5)：988-1004.

1. Hartrampf CR， Scheflan M， Black PW. Breast reconstruction with a transverse abdominal island flap[J]. Plast Reconstr Surg， 1982， 69(2)：216-225.
2. Gui GP， Kadayaprath G， Tan SM， et al. Evaluation of outcome after immediate breast reconstruction：prospective comparison of four methods[J]. Plast Reconstr Surg， 2005， 115(7)：1916-1926.
3. Ziswiler-Gietz J， Makrodimou M， Harder Y， et al. Outcome analysis of breast reconstruction with free transverse rectus abdominis musculocutaneous (TRAM) flaps[J]. Swiss Med Wkly， 2008， 138(7-8)：114-120.
4. 张学慧，尹健，张如明，等. 女性乳腺癌保留胸大肌术后Ⅰ期乳房再造[J]. 中国肿瘤临床， 2002， 29(7)：495-497.
5. Chun YS， Sinha I， Turko A， et al. Outcomes and patient satisfaction following breast reconstruction with bilateral pedicled TRAM flaps in 105 consecutive patients[J]. Plast Reconstr Surg， 2010， 125(1)：1-9.
6. Jemal A， Siegel R， Ward E， et al. Cancer statistics， 2006[J]. CA Cancer J Clin， 2006， 56(2)：106-130.
7. Kronowitz SJ， Hunt KK， Kuerer HM， et al. Delayed-immediate breast reconstruction[J]. Plast Reconstr Surg， 2004， 113 (6)：1617-1628.
8. 宣立学，穆兰花，张保宁. 整形外科技术在乳腺癌治疗中的应用[J]. 中国实用外科杂志， 2006， 26(4)：306-308.
9. Chagpar A， Langstein HN， Kronowitz SJ， et al. Treatment and outcome of patients with chest wall recurrence after mastectomy and breast reconstruction[J]. Am J Surg， 2004， 187(2)：164-169.
10. Sandelin K， Wickman M， Billgren AM. Oncological outcome after immediate breast reconstruction for invasive breast cancer：a long-term study[J]. Breast， 2004， 13(3)：210-218.
11. Cunnick GH， Mokbel K. Skin-sparing mastectomy[J]. Am J Surg， 2004， 188(1)：78-84.
12. 黄晓辉，陈凛，石怀银. 早期乳腺癌保留皮肤的保乳手术安全性研究[J]. 解放军医学杂志， 2007， 32(3)：258-259.
13. Ho CM， Mak CK， Lau Y， et al. Skin involvement in invasive breast carcinoma：safety of skin-sparing mastectomy[J]. Ann Surg Oncol， 2003， 10(2)：102-107.
14. Toth BA， Forley BG， Calabria R. Retrospective study of the skin-sparing mastectomy in breast reconstruction[J]. PlastReconstr Surg， 1999， 104(1)：77-84.
15. Kissin MW， Kark AE. Nipple preservation during mastectomy[J]. Br J Surg， 1987， 74(1)：58-61.
16. 曾健，陆云飞，林进令. 保留皮肤或保留乳头、乳晕的乳腺癌改良根治术后扩展型背阔肌肌皮瓣即时乳房再造[J]. 中国综合临床， 2005， 21(10)：897-899.
17. 王圣应，鲁智，程新德，等. 早期乳腺癌保留乳头乳晕的复合体的改良根治术——Ⅰ期腹直肌肌皮瓣重建乳房[J]. 癌症， 2004， 23(1)：56-59.
18. 高德宗，孙靖中，尹群生，等. 女性乳房手术预防乳头乳晕坏死的血供研究[J]. 中国普通外科杂志， 2005， 14(4)：269-272.
19. Slavin SA， Schnitt SJ， Duda RB， et al. Skin-sparing mastectomy and immediate reconstruction：oncologic risks and aesthetic results in patients with early-stage breast cancer[J]. PlastReconstr Surg， 1998， 102(1)：49-62.
20. Soong IS， Yau TK， Ho CM， et al. Post-mastectomy radiotherapy after immediate autologous breast reconstruction in primary treatment of breast cancers[J]. Clin Oncol， 2004， 16(4)：283-289.
21. 王仲照. 即刻乳房再造在乳腺癌治疗中的应用[J]. 癌症进展， 2005， 3(2)：144-150.
22. 薛秀丽，邱志丽，邹小明. 乳腺癌改良根治术后Ⅱ期应用腹直肌皮瓣重建乳房再造1例[J]. 哈尔滨医科大学学报， 2007， 41(5)：516-517.
23. 张立成. 乳腺癌术后乳房再造的进展[J]. 实用全科医学， 2007， 5(11)：1010-1011.
24. 汤学良，邹天宁，陈德滇，等. 乳腺癌改良根治术后自体肌皮瓣乳房重建21例[J]. 肿瘤学杂志， 2002， 8(6)：354．.
25. Mizgala CL， Hartrampf CR Jr， Bennett GK. Assessment of the abdominal wall after pedicled TRAM flap surgery：5- to 7-year follow-up of 150 consecutive patients[J]. Plast Reconstr Surg， 1994， 93(5)：988-1004.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Treatment Experience about The Skin-Sparing Mastectomy and Immediate Breast Reconstruction of 10 Cases

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