• 四川大學華西醫(yī)院甲狀腺乳腺外科（成都，610041）;

【摘要】　 乳腺癌乳房切除術后重建包括自體組織重建和假體重建兩大類。假體重建包括單純假體一步重建，組織擴張器后假體兩步重建，以及可調式雙囊假體一步重建?，F(xiàn)將如何通過幾種假體重建方式達到最佳的美容效果，以及各種假體重建方式的適應證、并發(fā)癥、患者滿意度等做一綜述。

引用本文： 羊曉勤,李宏江. 乳腺癌乳房切除術后假體重建. 華西醫(yī)學, 2011, 26(7): 1006-1009. doi: 復制

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1. 　Losken A, Jurkiewicz MJ. History of breast reconstruction[J]. Breast Dis, 2002, 16: 3-9.
2. 　Spear SL, Mardini S, Ganz JC. Resource cost comparison of implant-based breast reconstruction versus TRAM flap breast reconstruction[J]. Plast Reconstr Surg, 2003, 112(1): 101-105.
3. 　Blondeel N, Vanderstraeten GG, Monstrey SJ, et al. The donor site morbidity of free DIEP flaps and free TRAM flaps for breast reconstruction[J]. Br J Plast Surg, 1997, 50(5): 322-330.
4. 　Cordeiro PG. Breast reconstruction after surgery for breast cancer[J]. N Engl J Med, 2008, 359(15): 1590-1601.
5. 　Toth BA, Lappert P. Modified skin incisions for mastectomy: the need for plastic surgical input in preoperative planning[J]. Plast Reconstr Surg, 1991, 87(6): 1048-1053.
6. 　Babiera G, Simmons R. Nipple-areolar complex-sparing mastectomy: feasibility, patient selection, and technique[J]. Ann Surg Oncol, 2010, 17(Suppl 3): 245-248.
7. 　King MC, Marks JH, Mandell JB. Breast and ovarian cancer risks due to inherited mutations in BRCA1 and BRCA2[J]. Science, 2003, 302(5645): 643-646.
8. 　Meijers-Heijboer H, van Geel B, van Putten WL, et al. Breast cancer after prophylactic bilateral mastectomy in women with a BRCA1 or BRCA2 mutation[J]. N Engl J Med, 2001, 345(3): 159-164.
9. 　Rebbeck TR, Friebel T, Lynch HT, et al. Bilateral prophylactic mastectomy reduces breast cancer risk in BRCA1 and BRCA2 mutation carriers: the PROSE Study Group[J]. J Clin Oncol, 2004, 22(6): 1055-1062.
10. 　Salgarello M, Barone-Adesi L, Terribile D. Update on one-stage immediate breast reconstruction with definitive prosthesis after sparing mastectomies[J]. Breast, 2011, 20(1): 7-14.
11. 　Rohrich RJ, Reece EM. Breast augmentation today: saline versus silicone-what are the facts?[J]. Plast Reconstr Surg, 2008, 121(2): 669-672.
12. 　McLaughlin JK, Lipworth L, Murphy DK. The safety of silicone gel-filled breast implants: a review of the epidemiologic evidence[J]. Ann Plast Surg, 2007, 59(5): 569-580.
13. 　Winkler E, Regev E, Bar-Meir E. Silicone gel-filled breast implants and breast cancer-an update and safety[J]. Harefuah, 2004, 143(3): 222-226.
14. 　Tanne JH. FDA approves silicone breast implants 14 years after their withdrawal[J]. BMJ, 2006, 333(7579): 1139.
15. 　McCarthy CM, Klassen AF, Cano SJ, et al. Patient satisfaction with postmastectomy breast reconstruction: a comparison of saline and silicone implants[J]. Cancer, 2010, 116(24): 5584-5591.
16. 　Gui GP, Tan SM, Faliakou EC. Immediate breast reconstruction using biodimensional anatomical permanent expander implants: a prospective analysis of outcome and patient satisfaction[J]. Plast Reconstr Surg, 2003, 111(1): 125-138.
17. 　Salgarello M, Seccia A, Eugenio F. Immediate breast reconstruction with anatomical permanent expandable implants after skin-sparing mastectomy: aesthetic and technical refinements[J]. Ann Plast Surg, 2004, 52(4): 358-364.
18. 　Gahm J, Edsander-Nord A. No differences in aesthetic outcome or patient satisfaction between anatomically shaped and round expandable implants in bilateral breast reconstructions: a randomized study[J]. Plast Reconstr Surg, 2010, 126(5): 1419-1427.
19. 　Collis N, Coleman D, Foo IT. Ten-year review of a prospective randomized controlled trial of textured versus smooth subglandular silicone gel breast implants[J]. Plast Reconstr Surg, 2000, 106(4): 786-791.
20. 　Spear SL, Spittler CJ. Breast reconstruction with implants and expanders[J]. Plast Reconstr Surg, 2001, 107(1): 177-187.
21. 　Tebbetts JB. Dual plane breast augmentation: optimizing implant-soft-tissue relationships in a wide range of breast types[J]. Plast Reconstr Surg, 2001, 107(5): 1255-1272.
22. 　Strock LL. Two-stage expander implant reconstruction: recent experience[J]. Plast Reconstr Surg, 2009, 124(5): 1429-1436.
23. 　Cordeiro PG, McCarthy CM. A single surgeon’s 12-year experience with tissue expander/implant breast reconstruction: part I. A prospective analysis of early complications[J]. Plast Reconstr Surg, 2006, 118(4): 825-831.
24. 　Cordeiro PG, McCarthy CM. A single surgeon′s 12-year experience with tissue expander/implant breast reconstruction: part II. An analysis of long-term complications, aesthetic outcomes, and patient satisfaction[J]. Plast Reconstr Surg, 2006, 118(4): 832-839.
25. 　Nahabedian MY, Tsangaris T, Momen B, et al. Infectious complications following breast reconstruction with expanders and implants[J]. Plast Reconstr Surg, 2003, 112(2): 467-476.
26. 　Marques M, Brown SA, Oliveira I, et al. Long-term follow-up of breast capsule contracture rates in cosmetic and reconstructive cases[J]. Plast Reconstr Surg, 2010, 126(3): 769-778.
27. 　Christante D, Pommier SJ, Diggs BS, et al. Using complications associated with postmastectomy radiation and immediate breast reconstruction to improve surgical decision making[J]. Arch Surg, 2010, 145(9): 873-878.
28. 　Ascherman JA, Hanasono MM, Newman MI. Implant reconstruction in breast cancer patients treated with radiation therapy[J]. Plast Reconstr Surg, 2006, 117(2): 359-365.
29. 　Recht A, Edge SB, Solin LJ, et al. Postmastectomy radiotherapy: clinical practice guidelines of the American Society of Clinical Oncology[J]. J Clin Oncol, 2001, 19(5): 1539-1569.
30. 　Kronowitz SJ, Robb GL. Radiation therapy and breast reconstruction: a critical review of the literature[J]. Plast Reconstr Surg, 2009, 124(2): 395-408.
31. 　McCarthy CM, Pusic AL, Sclafani L, et al. Breast cancer recurrence following prosthetic, postmastectomy reconstruction: incidence, detection, and treatment[J]. Plast Reconstr Surg, 2008, 121(2): 381-388.
  1. 1. 　Losken A, Jurkiewicz MJ. History of breast reconstruction[J]. Breast Dis, 2002, 16: 3-9.
  2. 2. 　Spear SL, Mardini S, Ganz JC. Resource cost comparison of implant-based breast reconstruction versus TRAM flap breast reconstruction[J]. Plast Reconstr Surg, 2003, 112(1): 101-105.
  3. 3. 　Blondeel N, Vanderstraeten GG, Monstrey SJ, et al. The donor site morbidity of free DIEP flaps and free TRAM flaps for breast reconstruction[J]. Br J Plast Surg, 1997, 50(5): 322-330.
  4. 4. 　Cordeiro PG. Breast reconstruction after surgery for breast cancer[J]. N Engl J Med, 2008, 359(15): 1590-1601.
  5. 5. 　Toth BA, Lappert P. Modified skin incisions for mastectomy: the need for plastic surgical input in preoperative planning[J]. Plast Reconstr Surg, 1991, 87(6): 1048-1053.
  6. 6. 　Babiera G, Simmons R. Nipple-areolar complex-sparing mastectomy: feasibility, patient selection, and technique[J]. Ann Surg Oncol, 2010, 17(Suppl 3): 245-248.
  7. 7. 　King MC, Marks JH, Mandell JB. Breast and ovarian cancer risks due to inherited mutations in BRCA1 and BRCA2[J]. Science, 2003, 302(5645): 643-646.
  8. 8. 　Meijers-Heijboer H, van Geel B, van Putten WL, et al. Breast cancer after prophylactic bilateral mastectomy in women with a BRCA1 or BRCA2 mutation[J]. N Engl J Med, 2001, 345(3): 159-164.
  9. 9. 　Rebbeck TR, Friebel T, Lynch HT, et al. Bilateral prophylactic mastectomy reduces breast cancer risk in BRCA1 and BRCA2 mutation carriers: the PROSE Study Group[J]. J Clin Oncol, 2004, 22(6): 1055-1062.
  10. 10. 　Salgarello M, Barone-Adesi L, Terribile D. Update on one-stage immediate breast reconstruction with definitive prosthesis after sparing mastectomies[J]. Breast, 2011, 20(1): 7-14.
  11. 11. 　Rohrich RJ, Reece EM. Breast augmentation today: saline versus silicone-what are the facts?[J]. Plast Reconstr Surg, 2008, 121(2): 669-672.
  12. 12. 　McLaughlin JK, Lipworth L, Murphy DK. The safety of silicone gel-filled breast implants: a review of the epidemiologic evidence[J]. Ann Plast Surg, 2007, 59(5): 569-580.
  13. 13. 　Winkler E, Regev E, Bar-Meir E. Silicone gel-filled breast implants and breast cancer-an update and safety[J]. Harefuah, 2004, 143(3): 222-226.
  14. 14. 　Tanne JH. FDA approves silicone breast implants 14 years after their withdrawal[J]. BMJ, 2006, 333(7579): 1139.
  15. 15. 　McCarthy CM, Klassen AF, Cano SJ, et al. Patient satisfaction with postmastectomy breast reconstruction: a comparison of saline and silicone implants[J]. Cancer, 2010, 116(24): 5584-5591.
  16. 16. 　Gui GP, Tan SM, Faliakou EC. Immediate breast reconstruction using biodimensional anatomical permanent expander implants: a prospective analysis of outcome and patient satisfaction[J]. Plast Reconstr Surg, 2003, 111(1): 125-138.
  17. 17. 　Salgarello M, Seccia A, Eugenio F. Immediate breast reconstruction with anatomical permanent expandable implants after skin-sparing mastectomy: aesthetic and technical refinements[J]. Ann Plast Surg, 2004, 52(4): 358-364.
  18. 18. 　Gahm J, Edsander-Nord A. No differences in aesthetic outcome or patient satisfaction between anatomically shaped and round expandable implants in bilateral breast reconstructions: a randomized study[J]. Plast Reconstr Surg, 2010, 126(5): 1419-1427.
  19. 19. 　Collis N, Coleman D, Foo IT. Ten-year review of a prospective randomized controlled trial of textured versus smooth subglandular silicone gel breast implants[J]. Plast Reconstr Surg, 2000, 106(4): 786-791.
  20. 20. 　Spear SL, Spittler CJ. Breast reconstruction with implants and expanders[J]. Plast Reconstr Surg, 2001, 107(1): 177-187.
  21. 21. 　Tebbetts JB. Dual plane breast augmentation: optimizing implant-soft-tissue relationships in a wide range of breast types[J]. Plast Reconstr Surg, 2001, 107(5): 1255-1272.
  22. 22. 　Strock LL. Two-stage expander implant reconstruction: recent experience[J]. Plast Reconstr Surg, 2009, 124(5): 1429-1436.
  23. 23. 　Cordeiro PG, McCarthy CM. A single surgeon’s 12-year experience with tissue expander/implant breast reconstruction: part I. A prospective analysis of early complications[J]. Plast Reconstr Surg, 2006, 118(4): 825-831.
  24. 24. 　Cordeiro PG, McCarthy CM. A single surgeon′s 12-year experience with tissue expander/implant breast reconstruction: part II. An analysis of long-term complications, aesthetic outcomes, and patient satisfaction[J]. Plast Reconstr Surg, 2006, 118(4): 832-839.
  25. 25. 　Nahabedian MY, Tsangaris T, Momen B, et al. Infectious complications following breast reconstruction with expanders and implants[J]. Plast Reconstr Surg, 2003, 112(2): 467-476.
  26. 26. 　Marques M, Brown SA, Oliveira I, et al. Long-term follow-up of breast capsule contracture rates in cosmetic and reconstructive cases[J]. Plast Reconstr Surg, 2010, 126(3): 769-778.
  27. 27. 　Christante D, Pommier SJ, Diggs BS, et al. Using complications associated with postmastectomy radiation and immediate breast reconstruction to improve surgical decision making[J]. Arch Surg, 2010, 145(9): 873-878.
  28. 28. 　Ascherman JA, Hanasono MM, Newman MI. Implant reconstruction in breast cancer patients treated with radiation therapy[J]. Plast Reconstr Surg, 2006, 117(2): 359-365.
  29. 29. 　Recht A, Edge SB, Solin LJ, et al. Postmastectomy radiotherapy: clinical practice guidelines of the American Society of Clinical Oncology[J]. J Clin Oncol, 2001, 19(5): 1539-1569.
  30. 30. 　Kronowitz SJ, Robb GL. Radiation therapy and breast reconstruction: a critical review of the literature[J]. Plast Reconstr Surg, 2009, 124(2): 395-408.
  31. 31. 　McCarthy CM, Pusic AL, Sclafani L, et al. Breast cancer recurrence following prosthetic, postmastectomy reconstruction: incidence, detection, and treatment[J]. Plast Reconstr Surg, 2008, 121(2): 381-388.