摘要
乳腺癌作为全球女性发病率最高的恶性肿瘤,呈现早发趋势及城乡差异。乳腺癌外科治疗历经了根治性乳房切除术、保乳手术与系统治疗结合等阶段,逐步从"最大耐受治疗"转向"最小有效治疗",强调精准化、个体化与微创化。微创化方面,前哨淋巴结活检(SLNB)技术革新了腋窝淋巴结处理模式,减少了手术创伤和并发症风险。保乳手术加放疗成为重要治疗模式,显著提高了患者生活质量。新辅助治疗后达到病理完全缓解(PCR)的患者可能免除手术,为个体化治疗提供了新思路。射频消融术后免疫系统激活为乳腺癌治疗提供了新方向,腔镜和机器人手术在乳腺癌治疗中的应用逐渐增多,进一步推动乳腺癌手术的微创化;美观化方面,乳房重建技术包括假体重建、自体组织重建和联合重建技术,在乳腺癌外科手术之外,尽可能恢复患者乳腺的外观,显著改善了患者的生活质量。
Breast cancer,as the highest incidence rate of malignant tumors among women in the world,shows an early onset trend and urban-rural differences.Surgical treatment of breast cancer has gone through the stages of radical mastectomy,breast conserving surgery and systematic treatment,gradually shifting from"maximum tolerance treatment"to"minimum effective treatment",emphasizing precision,individualization and minimally invasive trauma.In terms of minimally invasive techniques,sentinel lymph node biopsy(SLNB)technology has revolutionized the management of axillary lymph nodes,reducing the risk of surgical trauma and complications.Breast conserving surgery combined with radiotherapy has become an important treatment mode,significantly improving the quality of life of patients.Patients who achieve complete pathological remission(PCR)after neoadjuvant therapy may be exempt from surgery,providing new ideas for personalized treatment.The activation of immune system after radiofrequency ablation provides a new direction for the treatment of breast cancer.The application of endoscopic and robotic surgery in the treatment of breast cancer is gradually increasing,further promoting the minimally invasive surgery of breast cancer;In terms of aesthetics,breast reconstruction technology includes implant based reconstruction,autologous tissue reconstruction,and combined reconstruction techniques.In addition to surgery for breast cancer,it can restore the appearance of the patient’s breast as much as possible,significantly improving the quality of life of the patient.
作者
李兴睿
夏文飞
Li Xingrui;Xia Wenfei(Department of Thyroid and Breast Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)
出处
《中华实验外科杂志》
2025年第4期594-598,共5页
Chinese Journal of Experimental Surgery
关键词
乳腺癌
保乳手术
乳房重建技术
Breast cancer
Breast conserving surgery
Breast reconstruction technology
