T4乳癌におけるマイクロサージャリーを用いた乳房一次再建と集学的治療  [in Japanese] Immediate Breast Reconstruction Using Microsurgery in Multidisciplinary Treatment for T4 Breast Cancer  [in Japanese]

Access this Article

Search this Article

Author(s)

    • 関堂 充 Sekido Mitsuru
    • 筑波大学医学医療系形成外科 Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Tsukuba
    • 相原 有希子 Aihara Yukiko
    • 筑波大学医学医療系形成外科 Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Tsukuba
    • 佐々木 薫 Sasaki Kaoru
    • 筑波大学医学医療系形成外科 Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Tsukuba
    • 大島 純弥 Ooshima Junya
    • 筑波大学医学医療系形成外科 Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Tsukuba
    • 明星 里沙 Myoujou Risa
    • 筑波大学医学医療系形成外科 Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Tsukuba
    • 坂東 裕子 Bando Hiroko
    • 筑波大学医学医療系乳腺内分泌外科 Department of Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba
    • 井口 研子 Iguchi Akiko
    • 筑波大学医学医療系乳腺内分泌外科 Department of Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba

Abstract

<p>T4乳癌は術前療法, 手術, 術後療法など, 集学的治療が必要になる。今回われわれは, T4乳癌に対する集学的治療のなかで乳房一次再建を経験したので報告する。2010年12月から2018年3月の期間に当科にて一次再建を行ったT4乳癌症例につき, 年齢, 切除術式, 欠損範囲, 再建術式, 合併症, 術前治療, 術後追加治療, 予後に関して調査した。患者数は10例, 年齢24歳〜65歳 (平均50.2歳) であった。切除術式は大胸筋温存乳房切除術7例, 大胸筋合併乳房切除術3例で, いずれも皮膚欠損を合併した。再建術式は対側穿通枝を血管付加吻合した有茎腹直筋皮弁7例, Free DIEP flap3例であった。術後治療は放射線療法+化学療法4 例, 放射線療法+内分泌療法4例, 放射線療法単独1例, 化学療法単独1 例であった。T4乳癌の乳房再建においては胸壁・皮膚の広範囲な再建が必要であり, 切除後の早期創治癒, 早期化学療法・照射開始のためにもマイクロサージャリーを用いた自家組織による再建は有用であった。</p>

<p>T4 breast cancer requires multidisciplinary treatment such as preoperative chemotherapy, surgery, postoperative radiation and chemotherapy. We report immediate breast reconstruction during multidisciplinary treatment for T4 breast cancer. We investigated the age, resection method, defect size, reconstruction method, complications, preoperative treatment, postoperative treatment and prognosis of patients with T4 breast cancer who underwent immediate breast reconstruction at our institution between December 2010 and March 2018. There were 10 patients, aged 24 to 65 years old (average 50.2 years old) . The resection methods were simple mastectomy in 7 and mastectomy with resection of the pectoral muscle in 3. The reconstruction methods were pedicled TRAM flap with additional anastomosis of the opposite side perforator in 7 and free DIEP flap in 3. Postoperative treatments consisted of radiation therapy and chemotherapy in 4, radiation therapy and hormone therapy in 4, radiation therapy alone 1, and chemotherapy alone in 1. As extensive defects must be reconstructed in T4 breast reconstruction, autologous tissue was useful for early wound healing after resection, enabling the early start of chemotherapy and radiation.</p>

Journal

  • Oncoplastic Breast Surgery

    Oncoplastic Breast Surgery 4(2), 33-38, 2019

    Japan Oncoplastic Breast Surgery Society

Codes

Page Top