Objective: To summarize the status of immediate breast reconstruction (IBR) after mastectomy in Beijing City, Tianjin City and Hebei Province. Methods: A retrospective analysis was made on the data of 382 cases with breast cancer who were treated and followed up successfully with immediate breast reconstruction after mastectomy from January 2012 to December 2016 in Beijing City, Tianjin City and Hebei Province. Clinic data of the followed-up 382 cases (all female, age (38.5±4.2) years (range: 24 to 70 years)), including general information, tumor information, sugery methods, and treatments after surgery were collected. The survival status, metastasis,complications and prognosis were followed up. Cosmetic effcet was evalated by Harris method, and life quality by Functional Assessment of Cancer Therapy-Breast scale (FACT-B). χ(2) test was used to compare the difference between year 2012 and year 2013 to 2016. Bonferroni method was used to correct the inspection level, which was 0.05/10=0.005. The trend of IBR rate (ratio of IBR to modified radical mastectomy) from 2013 to 2016 was analyzed by trend χ(2) test. Results: There was 46 cases in stage 0, 152 cases in stage Ⅰ, 165 cases in stage Ⅱ, 19 cases in stage Ⅲ. Twenty-five cases was treated by neoadjuvant chemotherapy, 231 by chemotherapy and 35 by radiotherapy. The proportion of implant reconstruction was 48.7% (186/382), more than expanded of 21.5% (82/382), with latissimus dorsi of 12.0% (46/382), TRAM of 8.9% (34/382), DIEP of 2.1% (8/382), and latissimus plus implant of 6.8% (26/382). According to the Harris standard, the excellent and good rate of the cosmetic effect of the reconstructed breast was 93.7%. The score of FACT-B was 108.20±16.9 (range: 67 to 144) 1 year postoperatively. Compared with 2012, the IBR rate was significant increased, till 2015, the IBR rate was 153/10 000 cases (χ(2)=47.028, P=0.000). Conclusions: There is a significant increase on IBR rate in Beijing City, Tianjin City and Hebei province by year. Most of cases received IBR is stage Ⅰ to Ⅱ. Implant reconstruction is the main reconstructive method. Postoperative cosmetic effects and quality of life are both meet patients' demon.
目的： 探讨京津冀地区乳腺癌术后即刻乳房重建（IBR）的现状。 方法： 回顾性分析2012年1月至2016年12月京津冀地区8家三甲医院收治并成功随访的382例乳腺癌术后IBR患者的临床资料。患者均为女性，年龄（38.5±4.2）岁（范围：24~70岁）。记录患者一般资料、肿瘤资料、手术方式和术后治疗方法，随访患者的生存状况、复发转移情况、严重并发症及转归，采用Harris法评价重建乳房美容效果，采用乳腺癌患者生命质量测定量表评价患者的总体生活质量。采用χ(2)检验分别比较2013—2016年各年与2012年IBR与乳腺癌改良根治术的比值（IBR率）的差异，并采用Bonferroni法将检验水准校正为0.005（0.05/10）；采用趋势χ(2)检验分析2013—2016年IBR率的变化趋势。 结果： 382例患者中，0期46例，Ⅰ期152例，Ⅱ期165例，Ⅲ期19例。接受新辅助化疗25例，辅助化疗231例，辅助放疗35例。分析手术方式：假体植入占48.7%（186/382），扩张器占21.5%（82/382），背阔肌占12.0%（46/382），横行腹直肌肌皮瓣占8.9%（34/382），腹壁下动脉穿支皮瓣占2.1%（8/382），背阔肌联合假体占6.8%（26/382）。重建乳房的美容效果优良率为93.7%（385/382）。术后6个月随访，患者生活质量评分为（108.2±16.9）分（范围：67~144分）。2012年IBR率仅为48/万，2013—2016年各年IBR率逐渐升高（趋势χ(2)=47.028，P=0.000），2015年达153/万。 结论： 京津冀地区乳腺癌术后IBR率逐年增长，接受IBR的患者绝大部分为Ⅰ~Ⅱ期，假体植入为主要重建方式，术后美容效果和生活质量评分都较好。.
Keywords: Breast implants; Breast neoplasms; Mammaplasty.