Abstract: The application of modified lengthening the internal upper pedicle reduction mammaplasty in breast conserving surgery: a report of 3 cases        WANG Zi-han*，XU-Biao，GAO Guo-xuan，et al. *Department of Galactophore and Thyroid Surgery，Beijing Friendship Hospital，Capital Medical University，Beijing 100050，China
Corresponding authors:ZHANG Zhong-tao,E-mail:zhangzht@ccmu.edu.cn;QU Xiang,E-mail:cqx3968@sina.com
WANG Zi-han and XU-Biao are the first authors who contributed equally to the article
Abstract    Objective    Try to use the modified operation of lengthening the internal upper pedicle to shrink the breast and lift it up in the breast cancer patients with mastoptosis. Methods    From April to October 2018,clinical data of 3 cases of breast cancer with large diameter of upper quadrant / lateral tumor and ptosis of breast were treated with modified and lengthened internal upper pedicle breast retraction and lifting operation in Department of Galactophore and Thyroid Surgery，Beijing Friendship Hospital，Capital Medical University were analized restopectively， and the postoperative complications and break-q score were observed. Results    There were no complications such as fat liquefaction, papillary areola complex necrosis occured. The comparation results between post- and pre-operation of Breast-Q evaluation in 6 months showed that the average scores of physical well-being,satisfaction with breasts, psychosocial well-being, sexual well-being were 96.7 vs. 66.7, 100.0 vs. 64.7, 100.0 vs 84.3, 97.7 vs. 88.0 respectively. Satisfaction with nipples after operation scores were all 20. The follow-up time was 13.7 months, 16.6 months and 19.3 months respectively,there was no recurrence. Conclusion    The modified lengthening of the internal superior pedicle breast reduction is suitable for the patients with large lesion diameter in the external superior and lateral quadrants. It can be relatively simple to repair the local defects after operation, improve breast ptosis and the patients' satisfaction with the appearance of the breast.

Key words: lengthening the inner upper pedicle, reduction mammoplasty, breast cancer, breast conserving surgery

摘要： 目的    探讨对伴有乳房下垂的乳腺癌病人使用改良延长内上蒂缩乳上提手术。方法    回顾性分析2018年4月至2018年10月首都医科大学附属北京友谊医院乳腺甲状腺外科收治的3例外上象限或外侧肿瘤直径较大且伴乳房下垂的乳腺癌病人行改良延长内上蒂缩乳上提手术的相关并发症和术后BREAST-Q评分。结果    3例病人病人术后均未出现脂肪液化、乳头乳晕复合体缺血坏死并发症。术后6个月BREAST-Q评分平均值与术前对比，生理状况评分为96.7分 vs. 66.7分，对乳房满意度评分为100.0分 vs 64.7分，社会心理状态评分为100.0分 vs. 84.3分,性心理健康状态评分为97.7分 vs. 88.0分,术后乳头满意度均为满分20分。随访时间分别为13.7个月、16.6个月、19.3个月，均未见复发事件。结论    改良延长内上蒂乳房缩小术适用于外上、外侧象限病灶直径较大的病人，可以相对简便地修复术后局部缺损，同时改善乳房下垂，提高病人对乳房外观的满意度。

关键词: 延长内上蒂, 乳房缩乳术, 乳腺癌, 保乳术