射频消融联合腔镜微创保乳治疗早期乳腺癌医学美学评价.pdfVIP

射频消融联合腔镜微创保乳治疗 早期乳腺癌的医学美学评价 但汉雷 石 汉平 崔彦 肖庆 张杰 郭文俊 李成林 雷振东 宋崇林 黄宗海 [摘要] 目的 评价射频消融(radiofrequencyablation，RFA)联合腔镜微创保乳治疗早期乳腺 癌的医学美学效果。方法 选择早期乳腺癌 （T1-2N0-1M0)单侧单发病例，在术前常规化疗的同时，对 乳腺肿瘤局部行B超引导下RFA治疗，然后行病变乳腺叶段切除和腔镜下前哨淋巴结染色活检与 选择性腋窝淋巴结微创清扫术。术后随访3年以上，通过问卷法自我评价医学美学效果，并与传统保 乳手术进行比较。结果 直径≤3cm[平均(2.10±0.83)cm，最小1.20cm，最大3.00cm]的早期 乳腺癌单侧单发共23例，肿瘤完全消融率95.6％ (22/23)，成功完成微创保乳术22例。RFA联合 腔镜微创保乳治疗不仅瘢痕微小，而且乳房外形和腋窝形态明显优于传统手术，患者自我评分满意率 100％，医学美学评分优良率95.5％(21/22)。结论 RFA联合腔镜微创保乳治疗早期乳腺癌可获 得更好的医学美学效果。 乳腺癌;射频消融;腔镜手术;保乳治疗;医学美学评价 Cosmeticassessmentofradiofrequencyablationcombinedwithendoscopicbreastconservationsurgervfor treatmentofearlybreastcancer DAN Han-leiSHIHan-pingCUIYan XIAOQingZHANG Jie GUOWen-junLICheng-lin LEIZhen-dong SONGChong-linHUANGZong-haiMini mallyInvasiveSurgeryCenterofOncology,520HospitalofPLA,Mianvang621000,China [Abstract] Objective Radiofrequencyablation(RFA)andendoscopicbreastconservingsurgery (EBCS)hasbeendevelopedasapotentialmeansfortreatingbreasttumorswithminimaldisruptionto adjacentsofttissues.ThepurposeofthisstudywastoevaluatethecosmeticoutcomesofRFAassisted byEBCSonpatientswithearlybreastcarcinoma(T1-2N0-1M0).Methods Twenty-threepatientswith biopsyproveninvasivebreastcarcinoma(≤3cmindiameter),weretreatedwithultrasound(US) guidedpercutaneous-RFAforthelocaltumorsfollowedbysentinellymphnodebiopsyandendoscopic auxiliarynodedissectionandlumpectomy.Thereactionstobreastcosmeticswereobservedandcom paredtotheconventionalapproachesusingthebreastasymmetryscoreforEBCSandaself-assessment questionnairetargetingobjectiveandsubjectivedataabouttreatmentrelatedbreastchange. Results Twenty-threepatientsweresuccessfullytreatedwithRFA. Completecoagulationnecrosisofthe tumorwasvisualizedatUSandmammographyin22of23patients(95.6％).22patientsbeingper formedRFAandEBCSpresentedlittlescarsandthebreastspreservedmorecosmeticallyacceptable thanthereportedresultsoftraditionalprotocols.Self-assessmentacceptableratew