前胸壁全層切除後再建術を施行した術後19年目の再発乳癌の1例  [in Japanese] A CASE OF RECURRENT BREAST CANCER TO THE ANTERIOR CHEST WALL 19 YEARS AFTER A STANDARD RADICAL MASTECTOMY  [in Japanese]

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Abstract

症例は67歳,女性. 1976年9月に左乳癌(T2n0M0, stage I,浸潤性乳頭腺管癌)にて定型的乳房切断術を受けている. 1994年12月頃左前胸部の腫瘤に気づいたが放置していた.徐々に腫瘤が増大するため1995年8月当科を受診し,穿刺細胞診にてclass Vであり,乳癌の胸壁再発と診断した. ADM, 5-FUの左内胸動脈からの動注および50Gyの放射線照射を行った後に,胸壁全層切除術を施行した.再建は,骨性胸郭はMarlex meshとレンジ板を用い,軟部組織は対側の大胸筋弁を補填した.術後経過は良好であった.乳癌の胸壁局所再発例に対して,積極的に考慮すべき治療法と考えられた.

We report a case of recurrent breast cancer to the anterior chest wall 19 years after a radical mastectomy for a left breast cancer (T2n0M0, Stage I). A 67-year-old woman was seen at the hospital because of a gradually enlarging tumor in the anterior chest wall which strated 8 months before when she first noticed it. A needle biopsy cytology revealed class V and she was diagnosed as hoving recurrent breast cancer. After one cource of chemotherapy into the left internal thoracic artery and irradiation at 50Gy, a total layer resection of the chest wall involving the sternal body was carried out. The defect in the chest wall was reconstructed with Marlex mesh, acrylic resion and myocutaneous flap made of the pectoralis major muscle. Postoperative course was uneventful and there has been no sign of infection. It is thought that our procedure described here should be actively considered for the patient with local recurrence of breast cancer to the chest wall.

Journal

  • The journal of the Japanese Practical Surgeon Society

    The journal of the Japanese Practical Surgeon Society 58(2), 341-345, 1997-02-25

    Japan Surgical Association

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