背景:乳腺癌是一种主要影响女性的普遍恶性肿瘤,对他们的总体健康产生了明显的影响。主要的治疗方法,包括外科手术,通常会导致乳房切除术,可能引发心理动荡和紊乱。
方法:一名患者于2023年5月5日入院,原因是在入院前3天进行常规体格检查时发现双侧乳腺肿块。
方法:乳房是对称的,右乳头倒置,右乳外上象限有明显肿块,测量约5厘米×4厘米。质量很牢固,边界模糊,相对规则的形态,流动性差,没有温柔。门诊彩色多普勒超声显示右乳不均匀回声,分类为乳腺影像学报告和数据系统(BI-RADS)类别0,以及多个导管扩张。左乳房表现出低回声区域(BI-RADS3),指示增殖变化。X线摄影证实右乳弥漫性改变(BI-RADS0)和左乳增生征象(BI-RADS2)。活检结果显示明显的不典型导管增生与中间级别导管原位癌一致。该患者被诊断为右乳腺导管原位癌(cTisN0M0和0期),伴有左乳房肿块。
方法:2023年5月15日,患者再次入院接受进一步手术治疗。在进行相关辅助检查后,患者接受了保留乳头乳晕复合体的右乳房根治术,右腋窝前哨淋巴结活检,基于假体的右乳房乳房重建,5月17日左侧乳腺肿块显微切开术。
结果:患者在严格的围手术期监督下成功康复,术后7天出院。
结论:腋下入路用于内镜下乳腺切除和即刻种植重建,允许患者在接受常规药物治疗的同时保持女性形式的美学。这种方法大大提高了患者的心理生理健康,从而标志着它是值得在医学界广泛传播的有利做法。
BACKGROUND: Breast cancer represents a prevalent malignancy that primarily impacts women, with pronounced consequences on their overarching health. The major therapeutic approach, encompassing surgical procedures, can often culminate in mastectomy, potentially inciting psychological turmoil and disorders.
METHODS: A patient was admitted to our facility on May 5, 2023, precipitated by the discovery of bilateral breast masses during a routine physical examination conducted 3 days before admission.
METHODS: The breasts were symmetric, with the right nipple inverted and a palpable mass in the upper outer quadrant of the right breast, measuring approximately 5 cm × 4 cm. The mass was firm with indistinct borders, relatively regular morphology, poor mobility, and no tenderness. Outpatient color Doppler ultrasound revealed heterogeneous echogenicity in the right breast, classified as Breast Imaging Reporting and Data System (BI-RADS) category 0, along with multiple ductal dilatations. The left breast exhibited a hypoechoic area (BI-RADS 3), indicative of proliferative changes. Radiographic mammography confirmed diffuse changes in the right breast (BI-RADS 0) and proliferative signs in the left breast (BI-RADS 2). Biopsy results reveal significant atypical ductal hyperplasia consistent with intermediate-grade ductal carcinoma in situ. This patient was diagnosed as ductal carcinoma in situ of the right breast (cTisN0M0 and Stage 0), accompanied by a left breast mass.
METHODS: On May 15, 2023, the patient was readmitted for further surgical intervention. Following relevant auxiliary examinations, the patient underwent nipple-areola complex-sparing radical mastectomy for the right breast, sentinel lymph node biopsy in the right axillary area, prosthesis-based breast reconstruction for the right breast, and microrotatotomy of the left breast mass on the left side on May 17.
RESULTS: The patient made a successful recovery under scrupulous perioperative supervision and was discharged 7 days post-surgery.
CONCLUSIONS: The axillary approach for endoscopic mammary gland excision and immediate implant reconstruction permits patients to preserve the esthetics of the female form while undergoing conventional medical treatment. This methodology considerably enhances the psychophysical health of the patients, thereby marking it as an advantageous practice worthy of broad dissemination in the medical community.