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肿瘤整形外科保乳手术将肿瘤外科原则与整形外科原则进行融合，以改善保乳手术的美观效果，目标是获取与乳房切除术相当的生存、美观效果可接受的乳房、乳房经治疗后的肿瘤低复发率，适用于大多数早期乳腺癌女性，不过存在明确的禁忌证，如多发病灶以及手术切缘持续阳性。为了实现最佳保乳手术效果，在保持乳房外观的同时，必须在切除肿瘤时有足够的手术切缘。 2017年6月3日，美国《乳腺癌研究与治疗》在线发表瑞士乳腺中心、巴塞尔大学医院、圣加仑乳腺中心、苏黎世乳腺中心、巴登乳腺中心、卢塞恩州立医院、卢加诺地区医院、卢塞恩圣安娜医院、美国纽约纪念斯隆凯特林癌症中心、奥地利维也纳医科大学、格拉茨医科大学、萨尔斯堡大学医院、帕拉塞尔斯医科大学、维也纳威廉明尼市立医院、德国海德堡大学医院、图宾根大学乳腺中心、柏林大学医学中心、杜塞尔多夫大学医院、法兰克福大学医院、慕尼黑英国花园乳腺中心、罗斯托克大学医院的肿瘤整形乳房保留手术标准化首次国际共识会议报告。 该报告为了从国际乳腺外科专家小组（包括德国、奥地利、瑞士的乳腺病学会代表）获得肿瘤整形外科保乳手术标准化的共识推荐意见，通过电子投票共解决了52个问题。专家小组推荐意见与现有证据相关，该报告以公开的电子邮件反复征询意见过程，直至达成共识。
因此，当用于临床实践时，专家小组推荐意见可以提高肿瘤整形外科保乳手术的安全性和有效性。参会者一致认为，有必要进行多中心前瞻研究，以优化患者选择，并制定规范对肿瘤整形外科保乳手术培训中心的评审和认证进行标准化。 相关阅读 Breast Cancer Res Treat. 2017 Jun 3. [Epub ahead of print] First international consensus conference on standardization of oncoplastic breast conserving surgery. Weber WP, Soysal SD, El-Tamer M, Sacchini V, Knauer M, Tausch C, Hauser N, Günthert A, Harder Y, Kappos EA, Schwab F, Fitzal F, Dubsky P, Bjelic-Radisic V, Reitsamer R, Koller R, Heil J, Hahn M, Blohmer JU, Hoffmann J, Solbach C, Heitmann C, Gerber B, Haug M, Kurzeder C. University Hospital Basel, Basel, Switzerland; Memorial Sloan Kettering Cancer Center, New York, USA; Breast Center St. Gallen, St. Gallen, Switzerland; Breast-Center Zurich, Zurich, Switzerland; Breast Center Hirslanden Clinics Aarau Cham Zug and frauenarztzentrum aargau ag, Baden, Switzerland; Cantonal Hospital of Lucerne, Lucerne, Switzerland; Ospedale Regionale di Lugano (ORL), Breast Centre of Switzerland (CSSI), Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland; Medical University Vienna, Vienna, Austria; Breast Center, Hirslanden Klinik St. Anna, Lucerne, Switzerland; Medical Univerisity Graz, Auenbruggerplatz, Graz, Austria; University Clinic Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria; Wilhelminenspital der Stadt, Vienna, Austria; Universitats-Brustzentrum, Universitats-Frauenklinik, Im Neuenheimer Feld, Heidelberg, Germany; University Breast Center Tubingen, Tübingen, Germany; Charité Universitatsmedizin Berlin, Berlin, Germany; University Hospital Düsseldorf, Moorenstrasse, Düsseldorf, Germany; University Hospital Frankfurt, Frankfurt, Germany; Breast Center at the English Garden, Munich, Germany; University Hospital Rostock, Suedring, Rostock, Germany. PURPOSE: To obtain consensus recommendations for the standardization of oncoplastic breast conserving surgery (OPS) from an international panel of experts in breast surgery including delegates from the German, Austrian and Swiss societies of senology. METHODS: A total of 52 questions were addressed by electronic voting. The panel's recommendations were put into context with current evidence and the report was circled in an iterative open email process until consensus was obtained. RESULTS: The panelists considered OPS safe and effective for improving aesthetic outcomes and broadening the indication for breast conserving surgery (BCS) towards larger tumors. A slim majority believed that OPS reduces the rate of positive margins; however, there was consensus that OPS is associated with an increased risk of complications compared to conventional BCS. The panel strongly endorsed patient-reported outcomes measurement, and recommended selected scales of the Breast-Q-Breast Conserving Therapy Module for that purpose. The Clough bi-level classification was recommended for standard use in clinical practice for indicating, planning and performing OPS, and the Hoffmann classification for surgical reports and billing purposes. Mastopexy and reduction mammoplasty were the only two recognized OPS procedure categories supported by a majority of the panel. Finally, the experts unanimously supported the statement that every OPS procedure should be tailored to each individual patient. CONCLUSIONS: When implemented into clinical practice, the panel recommendations may improve safety and effectiveness of OPS. The attendees agreed that there is a need for prospective multicenter studies to optimize patient selection and for standardized criteria to qualify and accredit OPS training centers. KEYWORDS: Breast cancer; Breast conserving surgery; Breast surgery; Oncoplastic surgery PMID: 28578506 DOI: 10.1007/s10549-017-4314-5
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