经乳晕保乳手术联合常规腋窝淋巴结清扫治疗乳腺癌  

Transareolar breast-conserving surgery combined with open axillary lymph node dissection for breast cancer

作　　者：孟娜[1] 骆成玉[1] 杨齐[1] 林华[1] 张键[1] 黄旋[1] 关琛[1] 薛镭[1] 张泽斌[1] 邹日成[1] 

机构地区：[1]首都医科大学附属北京复兴医院普外科暨乳腺疾病微创治疗中心,北京100038

出　　处：《中国微创外科杂志》2004年第5期388-389,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨经乳晕或乳腔镜辅助保乳手术联合常规腋窝淋巴结清扫治疗乳腺癌的效果。方法2001年8月～2003年11月,对19例直径<2cm、距离乳头>2cm的乳腺癌经乳晕或乳腔镜辅助行保乳手术,腋窝脂肪溶解抽吸后常规开放性腋窝淋巴结清扫。结果1例术中冰冻病理报告一侧切缘镜下癌残留,经扩大切除后转阴。术后2例乳房创面皮下积液,抽洗加压包扎消失。保留的乳房形态良好,伤口小而隐蔽,所有患者对手术效果满意。术后随访2～19个月,平均106月,未见乳腺和腋窝肿瘤复发。结论经乳晕或乳腔镜辅助下,借助乳腔镜器械可以方便地完成乳腺癌保乳手术,联合常规腋窝淋巴结清扫,手术效果肯定。Objective To probe the effect of transareolar or mastoscopy assisted breast-conserving surgery combined with open axillary lymph node dissection in the treatment of breast cancer. Methods Nineteen patients, with breast cancer of a diameter <2 cm and a distance >cm from the nipple, were treated by transareolar or mastoscopy assisted breast-conserving surgery from August 2001 to November 2003.After the lipolysis and suction of axillary fat,open axillary lymph node dissection was performed. Results Intraoperative frozen pathological examination had showed positive margin in 1 case, in which an enlarged excision was required to obtain a negative result. Postoperative subcutaneous edema underlying the operated site occurred in 2 cases and was cured by needle aspiration and pressure dressing. Excellent cosmetic outcomes were obtained with symmetrical breast development and all the patients were satisfied with the treatment. Postoperative follow-up for 2～19 months (mean, 10.6 months) found no recurrence in the breast or the axillary fossa. Conclusions Breast-conserving surgery can be expediently carried out by means of transareolar incision or with the help of mastoscopy. The combination with open axillary lymph node dissection may give favorable effect.

关 键 词：乳腺癌 保乳手术 乳腔镜 

分 类 号：R737.9[医药卫生—肿瘤]