Post-mastectomy breast reconstruction: procedure selection and management of common problems

doi:10.3877/cma.j.issn.1674-0785.2022.11.002

Abstract

Abstract:

Breast reconstruction rate among post-mastectomy breast cancer patient has been increasing both domestically and globally, and reconstruction patterns have also been broadened. Breast reconstruction, though with certain challenges ahead, has become one crucial part of surgical management of breast cancer and casts positive influence on the life quality of patients. This article summarizes the current status and commonly observed problems of post-mastectomy breast reconstruction, aiming at offering referential information for clinical practice.

Key words: Breast neoplasms, Breast reconstruction, Post-mastectomy, Management principles

Guangqian Shen, Hongchuan Jiang. Post-mastectomy breast reconstruction: procedure selection and management of common problems[J]. Chinese Journal of Clinicians(Electronic Edition), 2022, 16(11): 1039-1044.

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URL: https://zhlcyszz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0785.2022.11.002

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分级	表现
Ⅰ级	乳房质地柔软，不能看到或摸到假体
Ⅱ级	质地欠柔软，可以触及假体，不能看出假体轮廓
Ⅲ级	乳房质地坚硬，易于触及假体，可以看出假体轮廓，存在假体变形
Ⅳ级	严重包膜挛缩，乳房坚硬、疼痛，外观明显变形

分级	表现
Ⅰ级	乳房质地柔软，不能看到或摸到假体
Ⅱ级	质地欠柔软，可以触及假体，不能看出假体轮廓
Ⅲ级	乳房质地坚硬，易于触及假体，可以看出假体轮廓，存在假体变形
Ⅳ级	严重包膜挛缩，乳房坚硬、疼痛，外观明显变形

术式	材料
乳头复合组织瓣移植	对侧乳头组织
局部皮瓣	中央型皮瓣、皮下带蒂皮瓣、皮下带双蒂皮瓣、荷包式皮瓣
皮瓣联合自体组织填充	软骨、脂肪
皮瓣联合人工材料	硅胶、透明质酸、羟磷灰石钙、人工骨、聚四氟乙烯
皮瓣联合同种异体移植	脱细胞真皮

术式	材料
乳头复合组织瓣移植	对侧乳头组织
局部皮瓣	中央型皮瓣、皮下带蒂皮瓣、皮下带双蒂皮瓣、荷包式皮瓣
皮瓣联合自体组织填充	软骨、脂肪
皮瓣联合人工材料	硅胶、透明质酸、羟磷灰石钙、人工骨、聚四氟乙烯
皮瓣联合同种异体移植	脱细胞真皮

等级	标准
优	重建乳房与健侧体积基本相等，位置对称
良	重建乳房与健侧体积相近，着装后无明显差异
尚可	双侧明显不对称，着装后差别明显
差	重建乳房严重变形

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