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The article analyzes 472 patients diagnosed with breast cancer (breast cancer) who underwent radical subcutaneous/ skin-sparing mastectomy in combined or complex treatment. In the Department of Oncology and reconstructive plastic surgery of breast and skin mnioi them.P. A. Herzen radical skin-sparing mastectomy was performed in 255 (54.1 %) and radical subcutaneous mastectomy in 217 (45.9 %) patients. Reconstruction was carried out by autotissues, expander, followed by replacement with an endoprosthesis, as well as a combination of patches and endoprostheses. The mean age of patients was 43.8±2.2 (18-73) years. 11 (2,3±0,7 %) patients were diagnosed with relapse of breast cancer, while in 6 cases local and in 5 cases regional relapse (metastases in subclavian lymph nodes). Treatment of recurrences of breast cancer was as follows: in two cases, polychemotherapy courses were conducted, in 8 operations were performed - excision of relapse in the breast (3) and subclavian lymphadenectomy (2), removal of the reconstructed gland (3), in 1 case - radiation therapy. In 13 % recurrences of breast cancer were diagnosed at stage III OF breast cancer, the lowest percentage of relapse was 1.4 % at stage I. In luminal type A, recurrence of breast cancer was diagnosed in 1.8 %, in luminal B in 3.6 %, in triple negative type - 2.5 %, in luminal In Neg2 positive - 4.1 %. Metastases of breast cancer in our group of patients were diagnosed in 26 (5.5±1 %) patients. The highest percentage of long-term metastasis in our study revealed - 12.5 % at stage III, the lowest percentage of 3.4 at stage I breast cancer. 3-year overall survival of breast cancer patients in our group was 97.4 % (n=269).
References
Захарков Л.И. Подкожные радикальные мастэктомии с первичной реконструкцией при лечении больных раком молочной железы: диссертация.. к.м.н. Москва, 2006 - 113 с.
Зикиряходжаев А.Д., Рассказова Е.А. Рецидивы рака молочной железы после подкожных радикальных мастэктомий с одномоментной реконструкцией // Исследования и практика в медицине. - 2014. - Т. 1. - № 1. - С. 24-28.
Зикиряходжаев А.Д., Волченко H.H., Сарибекян Э.К., Рассказова Е.А. Поражение сосково-ареолярного комплекса у больных раком молочной железы // Вопросы онкологии. - 2017. - Т. 63. - № 4. - С. 593-597.
Канаев С.В. Роль лучевой терапии в лечении рака молочной железы // Практическая онкология. - 2002. - Т. 3. - № 1. - С. 45-51.
Каприн А.Д., Старинский В.В., Петрова ГВ. Состояние онкологической помощи населению России в 2017 году. - М., 2018. - С. 236.
Куклин И.А. Оптимизация хирургического лечения и реабилитации при опухолях молочной железы. Автореф. на соиск. д.м.н. - Иркутск, 2009. - 35 с.
Малыгин С.Е., Малыгин Е.Н., Петерсон С.Б., Протасов А.В., Беневский А.И. Местные и региональные рецидивы после мастэктомии с одномоментной реконструкцией при раке молочной железы // Вестник РГМУ. - 2013. - № 4. - С. 24-27.
Шивилов Е.В. Прогностические факторы в выборе оптимального объема операции у больных раком молочной железы. - Диссертация канд.мед.наук., 2009. - С. 170.
Хмелевский Е.В. Лучевая терапия рецидивов рака молочной железы // Вопр.онкол. - 2000. - Т. 46. - № 2. - С. 167-171.
Aalders K.C., Bommel A.C., Dalen Т. Contemporary risks of local and regional recurrence and contralateral breast cancer in patients treated for primary breast cancer // European Journal of Cancer. - 2016. - Vol. 63. - P. 118-126.
Arvold N.D., Taghian A.G., Niemierko A. Age, Breast Cancer Subtype Approximation, and Local Recurrence After Breast-Conserving Therapy // Journal of clinical oncology. 2011. - Vol. 29. - № 29. - P. 3885-3891.
Billar JA, Dueck AC, Gray RJ. et al. Preoperative predictors of nipple-areola complex involvement for patients undergoing mastectomy for breast cancer // Ann Surg Oncol. - 2011. - Vol. 18(11). - P. 3123-3128.
Castaneda С.А., Rebaza P., Castillo М. Critical review of axillary recurrence in early breast cancer // Critical Reviews in Oncology / Hematology. 2018. - Vol. 129. - P. 146-152.
D'Alonzo M1, Martincich L, Biglia N. et al. Clinical and radiological predictors of nipple-areola complex involvement in breast cancer patients // R. Eur J Cancer. - 2012. - Vol. 48(15). - P. 2311-2318.
Fisher B., Anderson S., Fisher E., et al. Significance of ipsilateral breast tumour recurrence after lumpectomy // The Lancet. - 1991. - Vol. 338 (8763). - P. 327-331.
Fisher В., Anderson S., Redmond C.K. et al. Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer // N. Engl. J. Med. - 1995. - Vol. 333. - P. 1456.
Huang N., Liu М., Chen. J. Surgical management of breast cancer in China. A 15-year single-center retrospective study of 18, 502 patients // Medicine. - 2016. - Vol. 95. - P 45-52.
Kris M.G., Benowitz S.I., Adams S. Успехи клинической онкологии 2010: наиболее значимые достижения в лечении, профилактике и скрининге онкологических заболеваний. Сообщение Американского общества клинической онкологии (ASKO) // Журнал клинической онкологии. - 2011. - Т. 5. - № 1. - С. 80-101.
Merino T., Ip Т., Dominguez F. et al. Risk factors for loco-regional recurrence in breast cancer patients: a retrospective study // Oncotarget. - 2018. - Vol. 9. - P. 30355-30362.
Missana MC, Laurent I, Germain M, Lucas S, Barreau L. Long-term oncological results after 400 skin-sparing mastectomies // Journal of Visceral Surgery. - 2013. - Vol. 150(5). - P. 313-320.
Slavin S.A., Schnitt S.J., Duda R.B. et al. Skin-sparing mastectomy and immediate reconstruction: oncologic risk and aesthetic results in patients with early-stage breast cancer // Plast. Reconstr. Surg. - 1998. - Vol. 102. - P. 49-62.
Yi.M., Kronowitz S.J., Meric-Bernstam F. et al. Local, regional, and systemic recurrence rates in patients undergoing skin-sparing mastectomy compared with conventional mastectomy // Cancer. - 2011. - Vol. 117(5). - P. 916-924.
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