Immediate Breast Reconstruction in 24 Patients after Nipple-sparing Modified Radical Mastectomy of Breast Cancer / 中国肿瘤临床

ABSTRACT

Objective: To explore the therapeutic effects of immediate breast reconstruction after modified radical mastectomy of breast cancer with nipple-areolar complex preservation and partial skin-sparing. Meth- ods- We studied 24 eady stage breast cancer patients who received immediate breast reconstruction after modified radical mastectomy with nipple-areolar complex preservation and partial skin-sparing. Nine patients had silicone prosthesis, 3 patients had transverse rectus abdominis myocutaneous flap (TRAM), and 12 pa-tients had silicone prosthesis combined with part of latissmus dorsi-myocutaneous flap (LDMF). The effects of breast reconstruction were evaluated according to objective and subjective criteria after surgery. Results: All of the 24 patients obtained successful breast reconstruction. The appearance of the reconstructed breast was perfect and the two sides seemed symmetrical. The aesthetic outcome was good in 23 patients and satisfacto-ry rate was up to 95.83%, and the subjective evaluation was up to 100%. Necrosis of part of the nipple was found in only one case. Hematoma appeared in one patient and vanished after 3 months. All patients received adjuvant chemotherapy after surgery. No local recurrence and distant metastasis occurred during the follow up period (5～48 months). One patient died of primary hepatic carcinoma at 2 years after surgery. Conclusion:Immediate breast reconstruction after modified radical mastectomy of breast cancer with preservation of nip-ple-areolar complex and partial skin-sparing is safe and effective for early stage breast cancer patients. The reconstructed breast is satisfactory. Breast reconstruction surgery is economical and can reduce patients' psy-chological pressure due to loss of the breast, and improve quality of life. Immediate breast reconstruction does not affect postoperative adjuvant therapy and long-term therapeutic effect. Breast reconstruction surgery has been gradually accepted by more and more eady stage breast cancer patients.