Nipple-sparing Mastectomy in Breast Cancer: From an Oncologic Safety Perspective

来源 :中华医学杂志(英文版) | 被引量 : 0次 | 上传用户:ddssdcsyqc
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
Objective:To evaluate the oncologic safety of nipple-sparing mastectomy (NSM) for breast cancer patients based on current literature.Data Sources:A comprehensive literature search ofMedline,Embase databases was conducted for studies published through March 2014.Study Selection:Our search criteria included English-language studies that focused on NSM at nipple-areola complex (NAC) involvement,patient selection,and recurrence.Prophylaxis NSM,case series or reports that based on very small population were excluded.In the end,42 studies concing NSM and oncological safety were included into the review.Results:NSM is a surgical procedure that allows the preservation of the skin and NAC in breast cancer patients or in patients with prophylactic mastectomy.However,the oncologic safety and patient selection criteria associated with NSM are still under debate.The incidence of NAC involvement of breast cancer in recent studies ranges from 9.5% to 24.6%,which can be decreased through careful patient selection.Tumour-nipple distance,tumour size,lymph node involvement and molecular characteristics can be evaluated preoperatively by clinical examinations,imaging studies and biopsies to predict the risk of NAC involvement.Currently,there is no available standard protocol for surgical approaches to NSM or pathological examination of NSM specimens.The local recurrence (ranges from 0% to 24%) of NSM is not significantly higher than that of traditional mastectomy in selected patients based on long-term follow-up.The role of radiotherapy in NSM is still controversial and is not universally accepted.Conclusions:NSM appears to be oncologically safe following careful patient selection and assessment of margins.
其他文献
天然免疫系统是抵御病原体的第一道防线,可保护宿主免受病毒等病原微生物的侵扰[1].宿主体内.树突状细胞(dendritic cell,DC)、巨噬细胞等抗原提呈细胞表达多样的模式识别受体(pattern-recognition receptors,PRR)能识别微生物结构,如脂质、核酸、碳水化合物中特殊的病原相关分子模式(pathogen associated molecular patterns
该文从挂篮荷载计算、施工流程、支座及临时固结施工、挂篮安装及试验、合拢段施工、模板制作安装、钢筋安装、混凝土的浇筑及养生、测量监控等方面人手,介绍了S226海滨大桥
传统的分解钨矿物原料的碱分解法或酸分解法只能处理单一的矿物黑钨精矿或白钨精矿.该方法在有关理论研究的基础上,将机械活化与分解的反应过程有机结合,形成一种处理各种钨
该文从挂篮荷载计算、施工流程、支座及临时固结施工、挂篮安装及试验、合拢段施工、模板制作安装、钢筋安装、混凝土的浇筑及养生、测量监控等方面人手,介绍了S226海滨大桥
Objective:To focus on the asthmatic pathogenesis and clinical manifestations related to epithelial sodium channel (ENaC)/chlorine ion channel.Data Sources:The d
目的探讨经尿道前列腺汽化电切术临床应用;方法对84例良性前列腺增生(BPH)患者行经尿道前列腺汽化电切术(TUVP),结果84例患者术后1例因为膀胱逼尿肌无力而行膀胱造瘘术,1例真
该文从挂篮荷载计算、施工流程、支座及临时固结施工、挂篮安装及试验、合拢段施工、模板制作安装、钢筋安装、混凝土的浇筑及养生、测量监控等方面人手,介绍了S226海滨大桥
期刊
@@
期刊
【摘要】目的:观察舒芬太尼复合罗哌卡因对股神经阻滞效果的影响,为临床麻醉用药提供选择依据。方法:ASAⅠ - Ⅱ级择期手术病人72例,年龄17 - 48岁,体重45 - 80kg,随机分为观察组(A组)和对照组(B组) ,每组36例。两组均选用0.15%罗哌卡因, A组为0.15%罗派卡因加入舒芬太尼10μg, B.组为单纯使用0.15%罗派卡因。常规监测血压、心率、血氧饱和度,两组病人行股神经阻
期刊