Tumors of female reproductive systemTumors of female reproductive systemОпухоли женской репродуктивной системы1994-40981999-8627Publishing House ABV Press86310.17650/1994-4098-2021-17-3-51-58MAMMOLOGY. REVIEWSМАММОЛОГИЯ. ОБЗОРНЫЕ СТАТЬИImpact of radiotherapy on long-term treatment outcomes in patients with breast cancer who have undergone simultaneous one-stage and two-stage reconstructive surgeries. Literature reviewВлияние лучевой терапии на отдаленные результаты лечения при одномоментных одно- и двухэтапных реконструктивнопластических операциях у больных раком молочной железы. Обзор литературыhttps://orcid.org/0000-0002-7261-8956BerestokT. S.БерестокТ. С.
Russian Federation

2/1 Bolshaya Pirogovskaya St., Moscow 119991; 3 2nd Botkinsky Proezd, Moscow 125284;  17/1 Baumanskaya St., Moscow 105005

119991 Москва, ул. Большая Пироговская, 2, стр. 1; 125284 Москва, 2-й Боткинский проезд, 3; 105005 Москва, ул. Бауманская, 17/1

berestok_t@mail.ruhttps://orcid.org/0000-0002-3888-8004ReshetovI. V.РешетовИ. В.
Russian Federation

2/1 Bolshaya Pirogovskaya St., Moscow 119991

119991 Москва, ул. Большая Пироговская, 2, стр. 1

https://orcid.org/0000-0001-7141-2502ZikiryakhodzhaevA. D.ЗикиряходжаевА. Д.
Russian Federation

2/1 Bolshaya Pirogovskaya St., Moscow 119991; 3 2nd Botkinsky Proezd, Moscow 125284

119991 Москва, ул. Большая Пироговская, 2, стр. 1; 125284 Москва, 2-й Боткинский проезд, 3

https://orcid.org/0000-0002-6619-6179GalkinV. N.ГалкинВ. Н.
Russian Federation

 17/1 Baumanskaya St., Moscow 105005

105005 Москва, ул. Бауманская, 17/1

https://orcid.org/0000-0002-4178-9592ErmoshchenkovaM. V.ЕрмощенковаМ. В.
Russian Federation

2/1 Bolshaya Pirogovskaya St., Moscow 119991;  17/1 Baumanskaya St., Moscow 105005

119991 Москва, ул. Большая Пироговская, 2, стр. 1; 105005Москва, ул. Бауманская, 17/1

AblitsovaN. V.АблицоваН. В.
Russian Federation

3 2nd Botkinsky Proezd, Moscow 125284

125284 Москва, 2-й Боткинский проезд, 3

https://orcid.org/0000-0001-7502-2288VlasovaM. Yu.ВласоваМ. Ю.
Russian Federation

3 2nd Botkinsky Proezd, Moscow 125284

125284 Москва, 2-й Боткинский проезд, 3

https://orcid.org/0000-0001-9146-7201OrtabaevaD. R.ОртабаеваД. Р.
Russian Federation

3 2nd Botkinsky Proezd, Moscow 125284

125284 Москва, 2-й Боткинский проезд, 3

I. M. Sechenov First Moscow State Medical University, Ministry of Health of RussiaФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова Минздрава РоссииP. A. Herzen Moscow Oncology Research Institute – a branch of the National Medical Radiology Research Center, Ministry of Health of RussiaМосковский научно-исследовательский онкологический институт им. П.А. Герцена – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава РоссииCity Clinical Cancer Hospital No. 1, Moscow Healthcare DepartmentГБУЗ «Городская клиническая онкологическая больница №1 Департамента здравоохранения Москвы»2910202117351582910202129102021https://ojrs.abvpress.ru/ojrs/article/view/863

The evolution in reconstructive breast surgery in the form of widespread use of implants allows you to abandon the “simple” mastectomy in most patients, provide faster rehabilitation and minimize the psychological trauma due to the absence of a breast. However, in most cases, radiation therapy and/or drug treatment are necessary, as they reduce the risk of relapse, disease progression and mortality. The combined or complex treatment increases the frequency of postoperative complications, such as prolonged wound healing, infection, protrusion/extrusion of the endoprosthesis, the development of capsular contracture, seroma, hematoma, etc. The greatest negative impact on the aesthetic result, both in the early and in the long-term period, is provided by remote radiation therapy. On the other hand, performing reconstructive plastic surgery may complicate radiation therapy. The issues of how long it is necessary to conduct radiation therapy, what type of reconstruction and how to conduct radiation therapy, how to minimize the frequency of complications without compromising the oncological and aesthetic results of treatment of breast cancer patients remain controversial.

Использование имплантатов в реконструктивной хирургии молочной железы позволяет отказаться от выполнения мастэктомии у большинства пациенток, обеспечить более быструю реабилитацию и минимизировать психологическую травму из-за отсутствия молочной железы. Лучевая и/или лекарственная терапия является необходимой частью комбинированного/комплексного лечения и снижает риск развития локального рецидива, прогрессирования заболевания и смерти. В свою очередь, проведение дополнительного лечения повышает частоту послеоперационных осложнений, таких как длительное заживление ран, инфицирование, протрузия/экструзия эндопротеза, развитие капсулярной контрактуры, серома, гематома и др. Дистанционная лучевая терапия существенно влияет на эстетический результат как в раннем, так и в отдаленном периоде, а выполнение реконструктивно-пластических операций может усложнить проведение лучевой терапии. Спорными остаются вопросы, в какие сроки и как необходимо проводить лучевую терапию, при каком виде реконструкции и как минимизировать частоту осложнений без ущерба для онкологических и эстетических результатов лечения больных раком молочной железы.

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