A Retrospective Analysis Of Different Quadrant Periareolar Incisions For The Treatment Of Breast Benign Diseases(10000Cases)

Objective:An evaluation of different quadrant periareolar incisions on the treatmentof breast benign diseases. Assess the nipple-areola clinical effects includingblood vessels, nerves, lymphatic and breast visual aesthetic effect and tactileaesthetic effect.Clinical research：During January2008to January2011in the Third Bethune Hospital ofJilin University,10000cases periareola incision in total (9630patiens) gotsurgery to cure breast benign tumors. We follow-up these patients for18monthsand analysis the clinicle data. That is,6215cases of Out-patientdepartment(6046persons),3785cases of Patient department (3584persons),age from15-82years, mean40.3years. According to the18monthsfollow-up, evaluate different quadrant periareolar incisions on the treatment ofbreast benign diseases. Assess the nipple-areola clinical effects including bloodvessels, nerves, lymphatic and breast visual aesthetic effect and tactile aestheticeffect.Methods:Anesthesia methods selected, local anesthesia or anesthesia.Take theperiareola incisions according to the tumor’s positions, blunt-free subcutaneousfat layer, excise the lesion completely with the electric knife or scissors.1or3days after the surgery, we have observed the nipple and areola blood supply,the nipple lymphatic drainage, assessment of the nipple and areola sensoryfunction, reflex function when changing dressing; after1month,6months,12months，18months, we have observed the breast shape, scar condition, nipple reflex,feeling, etc. and postoperative ultrasound to check for tumor recurrence.After18months,35cases of breast-feeding patients were observed whetherbreast-feeding was impacted, and have a comprehensive analysis on theperiareola incisions.Results:We have followed-up these patients for1month-18months and analysisof the clinicle data.5033cases have good blood supply of nipple and areola,good nipple and areola feeling, normal reflection, normal breast-feeding, thebreast tumor without recurrence after1month-18months, breast in goodshape, the scars were not significant.1980cases of upper outer quadrant group,1011cases of the inner upper quadrant group,1008cases of lower outerquadrant group,1024cases of lower inner quadrant group. In433cases nippleand areola were edema, lymphatic flow disorders. When we enhanced drainageand improved circulation,378cases have been cured, while55cases haven’t,13cases of the upper outer quadrant group,10cases of the inner upperquadrant group,11cases lower outer quadrant group,21cases lower innerquadrant group.4655cases nipple erection reflex declined when dressing. Insome patients after6-18months to review, nipple erection reflex have beenrestored in3656cases, while999cases haven’t,278cases of upper outerquadrant of group,185cases of upper inner quadrant of group,365cases oflower outer quadrant of group,171cases of lower inner quadrant of group.1503cases nipple and areola were hypoesthesia.6-18months after surgery997cases of sensory function have been recovery, while506cases haven’t,78casesof the upper outer quadrant group,116cases of the upper inner quadrant group,211cases of the lower outer quadrant group,101cases of the lower innerquadrant group;3in35patients breast-feeding were impacted. Of69cases in6-18months after surgery, scars were observed,the shape changed apparently,nipple collapsed, tumor recurrence. Of the62cases, nipple and areola blood supply were poor,40cases returned to normal after dressing.Conclusion:1. Periareolar incision surgical approach, has a small damage to normaltissue, less bleeding, less bad effects on nipple and areola blood supply; Theupper outer quadrant group has a less effect on areola blood supply than othergroups（P＜0.0167）.2. Different quadrant periareolar incisions,have different degree impactson of nipple and areola nerves, resulting in poor sensory and erectilereflexes.The lower outer quadrant group compared to the other three groups hasa poor recovery on nerve sensory function.3. Periareolar incision have better cosmetic results, breast symmetry,higher patient satisfaction, no significant difference between the various groups（P＞0.05）.4.Periareola incision has an impact on the lymphatic drainage,that theouter quadrant group compared to inner quadrant group decreases the events oflymphatic drainage of the nipple-areola complex（P＜0.0167）.5.Periareola incision for the treatment of benign breast lesions has obviousadvantages.Upper outer quadrant group has a lower incidence of adverseevents.