Relationship between breast reconstruction surgery and radiotherapy after mastectomy-a cross-sectional survey based on 110 hospitals in China

中华放射肿瘤学杂志 Pub Date : 2019-11-15 DOI:10.3760/CMA.J.ISSN.1004-4221.2019.11.002

Qi Zhang, Lun Li, B. Xiu, R. Guo, Benlong Yang, Jia Wang, Yonghui Su, W. Chi, Yingying Zhang, A. Cao, Z. Shao, Jiong Wu

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引用次数: 0

Abstract

Objective To investigate the current status of breast reconstruction surgery in China and analyze the specific views of Chinese doctors on the relationship between radiotherapy and breast reconstruction surgery. Methods A total of 110 medical institutions nationwide with more than 200 cases of breast cancer surgery yearly were selected into this questionnaire survey. The questionnaire survey included basic information of the surgeons and their hospitals, information of breast cancer surgeries in 2017, types of reconstruction surgery and specific views on the relationship between radiotherapy and reconstruction surgery. Results In total, 110 hospitals participated in the survey, 96(87.3%) had undergone breast reconstruction surgery. Reconstruction with implants accounted for 65.7% of the total reconstruction surgery and the proportion of autologous reconstruction was 20.1%. For patients who probably required postoperative radiotherapy, the preferred surgical procedure in the surveyed hospitals was implant based reconstruction surgery. For those who were confirmed to receive postoperative radiotherapy or had undergone radiotherapy after total mastectomy, autologous tissue reconstruction was recommended. Postoperative radiotherapy was a negative factor for immediate breast reconstruction, and most hospitals believed that radiotherapy exerted slight effect on surgery. The proportion of delay-immediate breast reconstruction reached 66% and 86% of hospitals preferred to replace with the prosthesis at 6 months after radiotherapy. Patients with local recurrence after breast-conserving surgery could also receive immediate reconstruction and implant reconstruction was the preferred surgical procedure. Conclusions The proportion of breast reconstruction in China is relatively low and Chinese doctors still lack of technical mastery. In the face of conflict with radiotherapy, the regime selected by Chinese doctors is not in accordance with those recommended by the guideline and consensus, prompting that more professional training should be delivered for Chinese doctors to further promote the development of breast reconstruction in China. Key words: Breast neoplasm/surgery; Breast reconstruction; Breast neoplasm/radiotherapy; Questionnaire

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乳腺重建手术与乳房切除术后放疗的关系——基于中国110家医院的横断面调查

目的了解我国乳腺重建手术的现状，分析我国医生对放疗与乳腺重建手术关系的具体看法。方法选择全国110家每年乳腺癌症手术200多例的医疗机构进行问卷调查。问卷调查包括外科医生及其所在医院的基本情况、2017年癌症乳腺癌手术情况、重建手术类型以及对放疗与重建手术关系的具体看法。结果共有110家医院参与调查，其中96家（87.3%）接受过乳房重建手术。植入物重建占重建手术总数的65.7%，自体重建的比例为20.1%。对于可能需要术后放疗的患者，调查医院首选的手术程序是基于植入物的重建手术。对于那些确认接受术后放疗或在乳房切除术后接受过放疗的患者，建议进行自体组织重建。术后放疗是立即乳房重建的一个负面因素，大多数医院认为放疗对手术的影响很小。延迟立即乳房重建的比例达到66%，86%的医院倾向于在放疗后6个月更换假体。保乳手术后局部复发的患者也可以立即进行重建，植入物重建是首选的手术程序。结论我国乳腺再造的比例相对较低，医生对技术的掌握程度还不够。面对与放疗的冲突，中国医生选择的方案与指南和共识建议的方案不一致，这促使中国医生应该接受更多的专业培训，以进一步促进中国乳房重建的发展。关键词：乳腺肿瘤/外科；乳房重建；乳腺肿瘤/放射治疗；调查表

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来源期刊

中华放射肿瘤学杂志

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发文量

6375

期刊介绍： The Chinese Journal of Radiation Oncology is a national academic journal sponsored by the Chinese Medical Association. It was founded in 1992 and the title was written by Chen Minzhang, the former Minister of Health. Its predecessor was the Chinese Journal of Radiation Oncology, which was founded in 1987. The journal is an authoritative journal in the field of radiation oncology in my country. It focuses on clinical tumor radiotherapy, tumor radiation physics, tumor radiation biology, and thermal therapy. Its main readers are middle and senior clinical doctors and scientific researchers. It is now a monthly journal with a large 16-page format and 80 pages of text. For many years, it has adhered to the principle of combining theory with practice and combining improvement with popularization. It now has columns such as monographs, head and neck tumors (monographs), chest tumors (monographs), abdominal tumors (monographs), physics, technology, biology (monographs), reviews, and investigations and research.