Abstract: Application of inframammary adipofascial flap in oncoplastic breast surgery for breast cancer: an analysis of 32 cases        ZHANG Bing, WANG Yu, ZHANG Kai-tong, et al. Breast Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100176, China
Corresponding author: GUAN Shan  E-mail: 13910777915@163.com
Abstract    Objective    To explore the use of inframammary adipofascial flaps in oncoplastic breast surgery for tumors in the lower quadrant of the breast. Methods    A retrospective analysis of 32 cases of expanded breast cancer resection in the lower quadrant of the breast and repair of breast defects with inframammary adipofascial flaps completed at the Breast Center of Beijing Tongren Hospital, Capital Medical University, from June 2019 to March 2022. The thickness of the subcutaneous fat in the upper abdominal wall was measured by CT or ultrasonography before surgery. During the volume replacement repair of the breast defect, the extent of the free inframammary adipofascial flaps was decided according to the enlarged tumor specimen volume. The operative time, postoperative drainage retention time, postoperative complications, and patients' satisfaction with the breast shape was recorded. Results    The thickness of subcutaneous fat in the inframammary was 1.6±0.3 cm. The specimen volume of tumor expansion resection in breast-conserving surgery: 68.2±15.7mm3. The operative time: 83.1±6.3 min. The postoperative drainage retention time: 9.5±0.9 days. The satisfaction with the cosmetic outcomes: strongly satisfied (78.1%), generally satisfied (21.9%). The postoperative complications: fat liquefaction: 5 cases (15.6%), seroma: 1 case (3.1%). Conclusion    In breast-conserving surgery for lower quadrant tumors, the use of inframammary adipofascial flaps to repair the breast defect can achieve good satisfaction with breast shape under the premise of ensuring tumor safety. The operation time is not significantly extended, and the postoperative complications are controllable, which is worthy of further confirmation by an expansion of the sample size.

Key words: breast neoplasms, breast conserving surgery, oncoplastic surgery 

摘要： 目的    探讨乳房下脂肪筋膜瓣在乳房下象限肿瘤保乳整形手术中的应用效果。方法    回顾性分析2019年6月至2022年3月首都医科大学附属北京同仁医院乳腺中心完成的乳房下象限乳腺癌扩大切除、乳房下脂肪筋膜瓣修复乳房缺损共32例病人资料。术前应用CT或超声检查测量乳房下皮下脂肪厚度；术中根据肿瘤扩大切除的标本体积决定乳房下脂肪筋膜瓣游离切取范围，完成对乳房缺损的容积替代修复，并对手术时间，术后引流管保留时间，术后并发症情况及乳房外形修复的满意度进行统计学分析。结果    病人乳房下皮下脂肪厚度为（1.6±0.3） cm。保乳手术的切除体积为（68.2±15.7） mm3。手术时间（83.1±6.3） min。引流管保留时间（9.5±0.9）d。术后乳房外形修复的满意度：优良25例（78.1%），中等7例（21.9%）。术后并发症：脂肪液化5例（15.6%），血清肿1例（3.1%）。结论    在乳房下象限肿瘤保乳手术中利用乳房下脂肪筋膜瓣修复乳房缺损，在保证肿瘤安全性的前提下，达到了良好的乳房外形修复满意度，未明显延长手术时间，术后并发症可控，值得进一步扩大样本量研究论证。

关键词: 乳腺肿瘤, 保乳手术, 肿瘤整形手术