Clinical Efficacy of Immediate Breast Reconstruction with Extended Latissimus Dorsi Musculocutaneous Flap after nipple and areola Sparing modified radical mastectomy for patients with Early-Middle Breast Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHOUTao , HUANGPing , MOJun-yang , ZHUANGYa-qiang

Department of Breast Thyroid Surgery, People's Hospital of Liuzhou City, Liuzhou 545006, Guangxi Zhuang Autonomous Region, China;

Corresponding author：

ZHOUTao, Email: doctorzhoutao23@sohu.com

Keywords：

Breast cancer; Extended latissimus dorsi musculocutaneous flap; Breast reconstruction; Modified radical mastectomy of breast cancer

DOI：

10.7507/1007-9424.20140049

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To explore the clinical efficacy of immediate breast reconstruction with extended latissimus dorsi musculocutaneous flap after nipple and areola sparing modified radical mastectomy for patients with early-middle breast cancer. Methods Sixty patients diagnosed with early-middle breast cancer by needle biopsy from November 2009 to October 2012 in this hospital were divided into two groups according to the surgical method.The breast reconstruction group (30 cases) were performed immediate breast reconstruction with extended latissimus dorsi musculocutaneous flap after nipple and areola sparing modified radical mastectomy, the control group (30 cases) were performed traditional modified radical mastectomy.The postoperative complications, clinical efficacy, quality of life, and recurrence and metastasis were compared in two groups. Results ①The ipsilateral breast was completely missing in the control group.The aesthetic effect in the breast reconstruction group was satisfactory including excellent in 22 patients, good in 7 patients, general in 1 patient.②The rates of flaps effusion, flap necrosis, and affectied limb activity limitation had no significant differences in two groups (P > 0.05).The wound healing time, operation area drainage time, hospital stay, and post-operative chemotherapy start time all had no significant differences in two groups (P > 0.05).③The frequency of psycho-logical pressure (inferiority/anxiety/fear) and rate of un-satisfaction of secondary sexual characteristics (body/curve) in the breast reconstruction group were lower than those in the control group (P < 0.001).The rate of social interaction fitness in the breast reconstruction group was higher than that in the control group (P < 0.001).④The following-up time was 12 to 38 months with an average 25 months, one case died because of brain metastasis in the control group, the rest 59 patients had no local recurrence and distant metastasis. Conclusions The immediate breast reconstruction with exte-nded latissimus dorsi musculocutaneous flap after nipple and areola sparing modified radical mastectomy can cure cancer on the basis of satisfactory cosmetic results of breast, excellent quality of life of patients, and fewer surgical complica-tions.It does not affect postoperative adjuvant radiochemotherapy and short-and long-term efficacy for breast cancer.

Citation： ZHOUTao, HUANGPing, MOJun-yang, ZHUANGYa-qiang. Clinical Efficacy of Immediate Breast Reconstruction with Extended Latissimus Dorsi Musculocutaneous Flap after nipple and areola Sparing modified radical mastectomy for patients with Early-Middle Breast Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(2): 212-216. doi: 10.7507/1007-9424.20140049 Copy

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1. Markopoulos C, Tsaroucha AK, Kouskos E, et al.Impact of breast cancer surgery on the self-esteem and sexual life of female patients[J].J Int Med Res, 2009, 37(1):182-188.
2. Rouanet P.Current position of breast reconstruction in oncology[J].Gynecol Obstet Fertil, 2002, 30(12):985-993.
3. 郭娜, 倪毅, 关炜.乳房再造术的研究进展[J].山西中医学院学报, 2008, 9(1):60-62.
4. 尹健, 张学慧, 张斌.即刻乳房再造与延期乳房再造的心理调查[J].中华整形外科杂志, 2005, 21(3):175-177.
5. Harris JR, Halpin-Murphy P, McNeese M, et al.Consensus statement on postmastectomy radiation therapy[J].Int J Radiat Oncol Biol Phys, 1999, 44(5):989-990.
6. 王圣应, 朱正志, 彭德峰, 等.保留乳头乳晕复合体的改良根治术治疗早期乳腺癌患者疗效分析[J].癌症, 2009, 28(4):408-411.
7. Mori H, Umeda T, Osanai T, et al.Esthetic evaluation of imme-diate breast reconstruction after nipple-sparing or skin-sparing mastectomy[J].Breast Cancer, 2005, 12(4):299-303.
8. 刘春生, 孙建伟, 贾玲, 等.保留乳头乳晕乳腺癌术后即刻乳房再造15例[J].实用临床医药杂志, 2011, 15(1):53-57.
9. Gerber B, Krause A, Reimer T, et al.Skin-sparing mastectomy with conservation of the nipple-areola complex and autologous reconstruction is an oncologically safe procedure[J].Ann Surg, 2003, 238(1):120-127.
10. 张斌, 冯锐, 葛洁, 等.背阔肌-胸大肌复合肌瓣即刻乳房再造研究[J].中国实用外科杂志, 2009, 29(9):752-755.
11. 徐桐, 金虹, 郝一莼.背阔肌皮瓣在乳腺癌术后乳房重建中的应用[J].亚太传统医药, 2011, 7(7):164-165.
12. 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.
13. 卓睿.即时扩展型背阔肌肌皮瓣乳房再造术常见失误及并发症探讨[J/CD].中华乳腺病杂志:电子版, 2010, 4(6):692-700.
14. 王亚兵, 陈剑平, 朱唯力.扩大背阔肌肌皮瓣在Ⅰ期乳房再造中的应用[J].实用医学杂志, 2010, 26(17):3182-3183.
15. 高海燕, 朱玉兰, 林维佳.10例保留皮肤的乳腺癌改良根治术后即时TRAM皮瓣乳房再造体会[J].中国普外基础与临床杂志, 2012, 19(9):962-966.
16. 蒋宏传, 苗蕊乳腺癌术后乳房重建进展[J].中国普外基础与临床杂志, 2010, 17(12):1221-1224.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Efficacy of Immediate Breast Reconstruction with Extended Latissimus Dorsi Musculocutaneous Flap after nipple and areola Sparing modified radical mastectomy for patients with Early-Middle Breast Cancer

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