The Application Of Partial Free Pectoralis Major Muscle Bundle To Fill The Nipple In The Nipple Sparing Mastectomy

ObjectiveTo observe the clinical value of partial free pectoralis major muscle bundle to fill the nipple in the Nipple Sparing Mastectomy.MethodsA total of 36 cases of breast cancer were retrospectively reviewed in the Department of Surgical breast,Weifang Hospital of traditional Chinese Medicine from July 2016 to July2017.Of these patients,36 cases underwent partial free pectoralis major muscle bundle to fill the nipple in the Nipple Sparing Mastectomy(observation group),and the other 26 cases underwent Nipple Sparing Mastectomy(control group).The projection and width of the nipple were measured at the time of surgery and at the fist year post surgery,respectively.The results of breast cosmetology were evaluated by Harris evaluation standard,and the safety of operation was compared by follow-up of recurrence,metastasis and adverse events.ResultsThe mean maintenance of nipple projection values was 91.75%±2.12%(range 87.7%～94.2%)and 81.73%±6.12%(range 92.7% ～ 67.1%)in groups observation and control,respectively(p<0.001).The mean maintenance of nipple widths was 93.63%±3.47%(range98.1% ～ 89.3%)and 90.12%±4.41%(range 96.7% ～ 78.4%)in groups observation and control,respectively(p<0.001).The maintenance of nipple projection and width was significantly increased in group B compared with group A.For the observation group,the number of cases rated as excellent,good,not bad,and bad levels of cosmetic outcomes were5,7,1and 0,respectively,and for the control group,the number was 3,7,10,and 3.The cosmetic outcomes of the observation group were significantly better than those of control group(p <0.01).One case with distant metastasis occurred in both the control group,and there was no significant difference(p >0.05).The postoperative complications were found in2 cases of the observation group and in 3 cases of the control group,respectively,but there was no significant difference(p =0.605).ConclusionThe partial free pectoralis major muscle bundle to fill the nipple is a useful and easy method to expand and augment the volume of nipples in Nipple Sparing Mastectomy.