부산대학교 도서관

Background: In breast reconstruction, complementary surgery on the contralateral breast is sometimes necessary to obtain a satisfactory aesthetic result. This complementary mammoplasty for symmetry gives the surgeon the opportunity to verify the state of the mammary glandular tissue to rule out a possible occult tumour in the contralateral breast. Our objective was to determine the prevalence of borderline lesions and of in situ and invasive carcinoma in specimens of the contralateral breast in a mammoplasty for symmetry in patients with breast cancer. Methods: We conducted a retrospective study of 145 breast reconstructions with mammoplasty for symmetry conducted at the Tours Regional Teaching Hospital in France. Results: The glandular histologic result after mammoplasty was normal in 45.5% of patients, with benign pathologies in 38.9% and borderline lesions in 15.6% of patients. No invasive or in situ carcinoma was detected. Conclusion: Systematic histologic analysis of glandular mammary tissue sampled after reduction mammoplasty in the particular context of breast reconstruction after breast cancer makes it possible to discover lesions that were not seen in presurgical evaluation. The early management of these borderline occult lesions could reduce the incidence of breast cancer in these at-risk patients. Contexte: Les reconstructions mammaires necessitent parfois un geste complementaire sur le sein controlateral pour un resultat esthetique satisfaisant. Cette chirurgie de symetrisation a l'avantage de donner l'opportunite au chirurgien d'analyser l'etat du tissu glandulaire pour eliminer une eventuelle tumeur controlaterale occulte. Notre but etait de determiner la prevalence des lesions frontieres, des cancers in situ et invasifs dans les specimens de plasties mammaires de symetrisation chez les patientes atteintes de cancer du sein. Methodes: Nous avons etudie retrospectivement 145 reconstructions mammaires avec une plastie mammaire de symetrisation realisee au centre hospitalier regional et universitaire de Tours. Resultats: L'examen histologique des resections glandulaires realisees apres mammoplastie est revenu normale dans 45,5 % des patientes, avec des pathologies benignes dans 38,9 % et des lesions frontieres dans 15,6 % des patientes. Il n'a pas ete retrouve de carcinome in situ ou invasif. Conclusion: L'analyse histologique systematique des tissus glandulaires preleves apres mammoplastie de reduction dans le contexte particulier de la reconstruction mammaire apres cancer du sein permet de mettre en evidence des lesions qui ont echappe au bilan pre-chirurgical. La prise en charge precoce de ces lesions frontieres occultes pourrait permettre de diminuer le nombre de cancers du sein incident chez ces patientes a risque.
An early diagnosis and the therapeutic approach to the management of breast cancer profoundly modify women's behaviour and their quality of life. (1) Moreover, mastectomy is often experienced as a [...]