Immediate reconstruction of the breast with implants and prolene mesh for early breast cancer

Quang Khánh Huỳnh
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Abstract

Abstract Introduction: Several techniques are available today for immediate breast reconstruction after mastectomy for breast cancer in early stage and the choice depends on patient condition, experience and surgeon skills. It is possible to use a definitive implant or a muscle flap to reconstruct breast, this procedure was performed under general anesthesia and immediately following a total mastectomy. While using a tissue expander requires two surgical procedures. Patients and methods: We study a series of patients with early breast cancer who underwent total mastectomy and immediate breast reconstruction with implants in a submuscular pocket created beneath the pectoralis major muscle and prolene mesh. The study has conducted at the Breast Department – Oncology Center of Cho Ray Hospital from 04/2020 to 04/2021. Results: There were 25 patients with early breast cancer (Stage 0: 6 cases, Stage IA: 2 cases, Stage IIA: 17 cases), in which, two cases had neoadjuvant therapy. A total of 17 nipple-sparing mastectomy reconstructions and 8 skin-sparing mastectomy reconstructions were performed during the study period. Mean age were 45,4 ± 9,2 years old (from 30 to 63). Mean operation time were 239 ± 26,4 minutes. No major complications were recorded. There is one case with skin redness and one case with partial nipple ischemia, these cases were stable when discharging from the hospital. In cosmetic aspect, results were excellent achieved 20% and good 80% respectivelly. The patients had been follow-up and treated with multi disciplinary specialty consultant after surgery, no case needs adjuvant radiotherapy. No recurrence or distal metastasis was recorded. Conclusion: Mastectomy and immediate breast reconstruction with implant in early breast cancer is feasible with strict condition. However, further studies with a larger sampling size and a follow-up are necessary to draw more validated conclusions. Keywords: breast cancer, immediate breast reconstruction.
早期乳腺癌植体及丙烯网即刻乳房重建
摘要简介:早期乳腺癌切除术后即刻乳房重建有几种技术可供选择,具体选择取决于患者的病情、经验和外科医生的技术。可以使用确定的植入物或肌肉瓣来重建乳房,这种手术是在全身麻醉下进行的,并在乳房全切除术后立即进行。而使用组织扩张器需要两个手术步骤。患者和方法:我们研究了一系列早期乳腺癌患者,他们接受了全乳切除术和立即乳房重建,在胸大肌和prolene网下方的肌下口袋中植入物。该研究于2020年4月至2021年4月在Cho Ray医院乳腺科肿瘤中心进行。结果:25例早期乳腺癌患者(0期6例,IA期2例,IIA期17例),其中2例接受了新辅助治疗。研究期间共施行保乳头乳房切除术重建术17例,保皮肤乳房切除术重建术8例。平均年龄45.4±9.2岁(30 ~ 63岁)。平均手术时间239±26.4 min。无重大并发症记录。1例皮肤发红,1例乳头局部缺血,出院时病情稳定。美容方面,优良率为20%,良率为80%。术后经多学科专科会诊医师随访治疗,无辅助放疗病例。无复发或远端转移记录。结论:在严格的治疗条件下,早期乳腺癌行乳房切除术和即刻假体乳房重建术是可行的。然而,进一步的研究需要更大的样本量和随访,以得出更有效的结论。关键词:乳腺癌;即刻乳房再造;
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