【摘要】 目的 局部晚期乳腺癌根治性切除联合皮瓣转移修复胸壁缺损的价值。方法 回顾性研究2018年1月至2023年6月于山东第一医科大学附属省立医院治疗的15例ⅢB、ⅢC期局部晚期乳腺癌患者临床资料。患者术前行多手段综合治疗，待局部病灶得到控制后予乳腺癌根治性手术，同时采用腹直肌或背阔肌肌皮瓣转移修复胸壁缺损。总结分析患者基本情况、治疗情况及随访情况。结果 截至2025年1月，15例患者中8例患者生存，7例患者死亡，总生存期为1036d(280～2237d)。15例患者病理亚型包括Luminal A型3例、Luminal B型4例、人表皮生长因子受体2阳性乳腺癌5例、三阴性乳腺癌3例。14例接受术前化疗，4例接受术前靶向治疗，5例接受术前介入治疗。5例采用背阔肌肌皮瓣、10例采用腹直肌肌皮瓣。术区复发3例。术后完成局部放疗9例，生存期为1423d(372～1498d);6例未行术后放疗，生存期为985.5d(280～2237d)。结论 综合治疗模式联合带蒂肌皮瓣修复技术，在局部晚期乳腺癌患者中有助于控制病灶，提高患者生存质量。更多还原

【Abstract】 Objective The value of radical resection of locally advanced breast cancer combined with flap transfer in the repair of chest wall defects. Method The clinical data of 15 patients with locally advanced breast cancer at stage Ⅲ B and Ⅲ C treated in Shandong Provincial Hospital Affiliated to Shandong First Medical University from January 2018 to June 2023 were retrospectively studied. The patients were treated by multiple means before operation. After the local lesions were controlled, the patients were treated with radical operation of breast cancer. At the same time, the rectus abdominis or latissimus dorsi myocutaneous flap was used to repair the chest wall defect. Summarize and analyze the basic situation, treatment and follow-up of patients. Result As of January 2025, 8 of the 15 patients survived and 7 died. The overall survival time was 1036d(280 ～ 2237d). The pathological subtypes of 15 patients included luminal type A(3 cases), luminal type B(4 cases), human epidermal growth factor receptor 2 positive breast cancer(5 cases) and triple negative breast cancer(3 cases). 14 cases received preoperative chemotherapy, 4 cases received preoperative targeted therapy, and 5 cases received preoperative interventional therapy. Latissimus dorsi myocutaneous flap was used in 5 cases and rectus abdominis myocutaneous flap in 10 cases. Recurrence occurred in 3 cases. The survival time was 1423 d(372 ～ 1498d); The survival time was 985.5d(280 ～ 2237d). Conclusion The comprehensive treatment mode combined with pedicled myocutaneous flap repair technology is helpful to control the lesions and improve the quality of life of patients with locally advanced breast cancer.更多还原