????? ?? ??????? BRCA

1
????? ?? ??????? BRCA
?"? ???? ???????? ????? ????????? ??????
??????? ?? ??? ?????? ????????? ?????? ???? ?????
??-????
2
??????? ????? ???

• ?? ???? ???-?????
• ???? ??????
• ?? ??????
• ????? ????
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• ???? ??????
• ????? ??????
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• ??? ????? ?????? ??? ?????

3
????? ?? ?????

• ????? ???? ???
• ????? ????? ????? ???
• ????? ??????? ?????
• ????? ?????- ????????
• ??? ????? ?????? ????? ?? ????? ???? ??????

• Cancer incidence in a cohort of Ontario and
  Quebec women having bilateral breast augmentation
  . Brisson J (Int Cancer Research)?
• Skin-sparing mastectomy and immediate
  reconstruction is an acceptable treatment option
  for patients with high-risk breast carcinoma.
  Downes KJ (cancer)?
• Recurrent breast cancer following immediate
  reconstruction with myocutaneous flaps, Slavin
  SA, (PRS)?

4
???? ??-?????

• ?????? ??
• ?????? ?????
• ????????
• ?????? ??
• ???? ?????
• ???????
• ??????????
• ????? ????????
• ???? ?????

5
????? ?? ????? ??? (SSM)?
6
???????? ????? ???

• ??? (????????)?
• ?????
• ???
• ???? ??? ??????? (???????)?
• ???
• ????
• ?????? ??????-???, ????
• ???? ??? ??????? ?????? ????
• ??

7
????? ????? ???

• ?????
• ???? ??-????
• ???
• ???????
• ??-???
• ???? \ ????? BECKER -
• ??? ????? ??-??? ??????? ???????
• ?????

8
(No Transcript)
9
???? ?????

• ????
• ???????
• ?? ???
• ????
• ????
• ???? (??????)?

10
????? ???????

• Acellular Dermal Matrix

11
????? ?????
12
????? ????? ???

• ???????
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• ???????? ?????
• ??? ???? ????
• ???? ????? ?? ??????
• ???? ?????? (????, ????)?
• ???? ??????
• ????
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13
????? ????? ???

• ???????
• ??? ?? (????? ?? 20)?
• ???????? ??????? (?? 10)?
• ???? (25-10 ????)?
• ??? ???????, ??????? ????
• ????? \ ??? ?????
• ????? ????
• ???? ?? ??? ????

14
????? ????? ??? ???????

• ???? ?????
• ???? - TRAM- Transverse Rectus Abdominis
  Myocutan
• ???? ??-?????
• ????? ?????
• ??? ?????
• DIEP Deep Inf Epigastric Perforator
• SIEA Superficial Inf Epigastric A
• ???? ??????
• ???? GLUTEUS ????? ?? ?????
• ??? ????? SGAP, IGAP -
• ???? ??????? ?????
• ???, ????

15
TRAM ????? ??-?????
16
TRAM ?????
17
????? ????? ?? ??? ????? ???? (DIEP, SIEA)?
18
Pre-op CT Angiography
19
(No Transcript)
20
????? ?? ???? ??????
21
????? ????? ??? ???????

• ???????
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• ??? ??? ??
• ????? ???
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• ??? ???????
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  ?? ???? ????? ??? ?? ????

22
????? ????? ??? ???????

• ???????
• ?????? ???? ????
• ????? ??????
• ??? ????
• ????? ????
• ?????, ?????
• ????? ????
• ????? ??? \ ???? ?? ?????

23
????? ?? ???? ??? ?????? ????

• ???? ????
• ??? ???? ?? ???? LATISSIMUS ???? ??????

24
????? ???? ?????

• ????? ????
• ??? ??? ??????
• ?????

• ????? ????
• ???? ??? ???????
• ????? ???? ?? ???
• ??????? ????, ????

25
???? ???