[SABCS2014]乳腺癌乳房整形及再造的时机和多学科团队协作——Krishna B. Clough访谈

作者:肿瘤瞭望   日期:2014/12/12 19:23:37  浏览量:72400

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Clough教授:肿瘤整形手术是一种可用于在乳腺癌患者肿瘤较大时避免乳房切除术的外科治疗技术。进行该手术时,我们需要对肿瘤进行广泛切除,并利用剩下的乳房组织在不应用假体、皮瓣的情况下进行乳房重塑,有点类似于乳房缩小术。

  Oncology Frontier : Yesterday during your talk, you commented on how you used to be obsessed with symmetry and you are not so much anymore. Could you elucidate on that?

  《肿瘤瞭望》:您在昨天的演讲中谈到您过去非常注重保持乳房的对称性,而现在则并不是那么注重了。能否请您详细说一下这方面的情况?

  Dr. Clough : Yes. I am a cancer surgeon and a plastic surgeon. I see patients for treatment and I see patients who come, having been operated with sequelae of their treatment. What we have been finding after a few decades is symmetry between two breasts is not a major point. Without any cancer, one patient, one woman out of three has an asymmetry between her two breasts. Most of them do not care about that. The real problem is after breast cancer surgery is treatments that leave a deformity. If a patient has a deformity or a retracted breast, then she considers herself as a breast cripple and she will demand more surgery to make her breasts look better. If she has a slight asymmetry, even up to 1/3 of the volume of the breast, that asymmetry might be detectable and then it is a patient choice to decide if she wants to reduce the other breast or if she does not want to. As a general rule for breast surgeons, when you operate on breast cancer patients, you can accept to leave an asymmetry between the two breasts. If you leave a deformity, that patient will be a breast cripple.

  Clough教授:是这样的。作为一名癌症外科医生及整形外科医生,我发现有很多来治疗的患者因既往手术后遗症而接受治疗。但实际上在几十年后我们发现两个乳房的不对称性并不是太大的问题。因为无乳腺癌的女性中有三分之一也是不对称的,但她们并不太关心这一点。其实,进行乳腺癌手术治疗后的真正问题在于对畸形进行治疗。如果患者存在畸形或乳房回缩,并认为自己的乳房外形有问题,则需进一步进行手术让其胸部看起来更好看。如果患者两侧乳房仅存在轻微肉眼可见的不对称,即使不对称部分已达到乳房体积的三分之一,我们也需尊重患者的意愿,让其自行决定是否缩小对侧乳房。对乳腺外科医生而言,我们一般可允许患者两个乳房不对称,但却不能让患者的乳房存在畸形。

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乳腺癌整形 再造多学科协作

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