文章：

一种无需重建的保留乳头乳房切除术新技术的初步疗效

Initial Outcomes of a Novel Technique of Nipple Sparing Mastectomy Without Reconstruction

原文发布日期：14 March 2025

DOI: 10.3390/cancers17060984

类型: Article

开放获取: 是

英文摘要：

Introduction:Nipple sparing mastectomy is oncologically safe and has a good cosmetic outcome. However, nipple sparing mastectomy was conventionally performed with reconstruction. Minimal scar mastectomy (MSM) is a novel technique which could allow women, with non-ptotic breasts, who do not want reconstruction, to conserve their nipple areolar complex (NAC) and avoid the transverse scar associated with modified radical mastectomy. This is the first study on the outcomes of MSM.Methods: MSM complications and their risk factors, recurrence rates and cosmetic outcomes were assessed. As MSM is a modification of the round block technique, the mean ring distance (MRD), which is the average of the distance between the inner and outer ring circumferentially, was assessed, too.Results:A total of 28 patients (29 breasts) were analysed. There was no recurrence after a mean/median follow-up of 40.3/41 months (4–80 months). In the initial recruitment of 17 patients (18 breasts), NAC necrosis occurred in eight cases (three complete, five partial). Prediabetes (p= 0.0128) and MRD ≥1.5 cm (p= 0.0440) were statistically significant for NAC necrosis. Of the available data, 11/15 (73.3%) rated the cosmetic outcome as excellent/good, with poorer cosmetic outcome correlated with NAC necrosis (p= 0.006). Avoiding the above risk factors in the next 11 patients, NAC necrosis decreased to 1/11 (9.0%) with mild ischaemia. Cosmetic outcome was rated as excellent/good in 90.9%.Conclusions:MSM is oncologically safe and is best performed in patients with no risk factors for NAC necrosis, including prediabetes and MRD < 1.5 cm. These pilot results will refine the selection criteria of patients for MSM.

摘要翻译： 

引言：保留乳头乳房切除术在肿瘤学上是安全的，且具有良好的美容效果。然而，传统上保留乳头乳房切除术需与重建手术联合进行。微创疤痕乳房切除术（MSM）是一种新技术，可使乳房无下垂且不愿接受重建手术的女性保留其乳头乳晕复合体（NAC），并避免改良根治性乳房切除术相关的横向疤痕。这是首项关于MSM效果的研究。 方法：评估了MSM的并发症及其风险因素、复发率和美容效果。由于MSM是环形切口技术的改良，还评估了平均环距（MRD），即内外环之间周向距离的平均值。 结果：共分析了28名患者（29个乳房）。平均/中位随访40.3/41个月（范围4-80个月）后，无复发。在最初招募的17名患者（18个乳房）中，8例发生NAC坏死（3例完全坏死，5例部分坏死）。糖尿病前期（p=0.0128）和MRD≥1.5厘米（p=0.0440）与NAC坏死具有统计学显著性。在可获得的数据中，11/15（73.3%）的患者将美容效果评为优秀/良好，较差的美容效果与NAC坏死相关（p=0.006）。在随后的11名患者中避免上述风险因素后，NAC坏死率降至1/11（9.0%），且为轻度缺血。90.9%的患者将美容效果评为优秀/良好。 结论：MSM在肿瘤学上是安全的，最适合无NAC坏死风险因素的患者，包括无糖尿病前期且MRD<1.5厘米的患者。这些初步结果将完善MSM患者的选择标准。

原文链接：

Initial Outcomes of a Novel Technique of Nipple Sparing Mastectomy Without Reconstruction