Thesis (Ph.D)-Cairo University, 2025.

Bibliography: pages 88-93.

The breast tissue is held in place by fibrous bands called ligaments of Cooper, which originate from the pectoralis fascia and extend into the skin and muscle.
These ligaments divide the breast tissue into septae and help suspend the breast to the chest wall. A horizontal fibrous septum also originates from the pectoralis fascia and provides medial and lateral lines of fixation on either side of the breast, while merging into the overlying skin. The lateral superficial ligament creates a strong connection between the pectoralis minor, skin, and overlying fascia of the axilla, producing the axillary hollow .The space between the breast and the pectoralis major fascia is known as the retromammary bursa, which facilitates the mobility of the breast on the chest wall

ﺳﺮﻃﺎﻥ ﺍﻟﺜﺪﻱ ﻫﻮ ﺃﻛﺜﺮ ﺃﻧﻮﺍﻉ ﺍﻟﺴﺮﻃﺎﻥ ﺷﻴﻮﻋﺎ ﺑﻴﻦ ﺍﻟﻨﺴﺎﺀ ﻭﺛﺎﻧﻲ ﺃﻛﺒﺮ ﺳﺒﺐ ﻟﻠﻮﻓﺎﺓ ﺑﺴﺒﺐ
ﺍﻟﺴﺮﻃﺎﻥ ﺑﻴﻦ ﺍﻟﻨﺴﺎﺀ. ﺍﻟﻌﻼﺝ ﺍﻟﺠﺮﺍﺣﻲ ﺍﻟﻤﺨﺘﺎﺭ ﻟﻬﺆﻻﺀ ﺍﻟﻤﺮﺿﻰ ﻫﻮ ﺇﻣﺎ ﺍﺳﺘﺌﺼﺎﻝ ﺍﻟﺜﺪﻱ ﺍﻟﺠﺬﺭﻱ ﺍﻟﻤﻌﺪﻝ ﺍﻭ ﺍﻻﺳﺘﺌﺼﺎﻝ ﺍﻟﺘﺤﻔﻈﻰ ﺍﻋﺘﻤﺎﺩﺍ ﻋﻠﻰ ﻣﺮﺣﻠﺔ ﺍﻟﻤﺮﺽ.
ﻟﻘﺪ ﺗﺤﻮﻟﺖ ﺟﺮﺍﺣﺔ ﺳﺮﻃﺎﻥ ﺍﻟﺜﺪﻱ ﻣﻦ ﺍﺳﺘﺌﺼﺎﻝ ﺍﻟﺜﺪﻱ ﺍﻟﺠﺬﺭﻱ ﺇﻟﻰ ﺟﺮﺍﺣﺔ ﺍﻟﺜﺪﻱ ﺍﻟﺘﺤﻔﻈﻴﺔ ﻣﻨﺬ ﺃﻭﺍﺋﻞ ﺍﻟﺴﺒﻌﻴﻨﻴﺎﺕ.ﻭﻟﻘﺪ ﻏﻴﺮ ﺍﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ ﺟﻮﺩﺓ ﺣﻴﺎﺓ ﺍﻟﻤﺮﺿﻲ.
ﻳﺠﺐ ﺃﻥ ﺗﻮﻓﺮ ﺟﺮﺍﺣﺔ ﺍﻟﺜﺪﻱ ﺍﻟﻨﺎﺟﺤﺔ ﻟﻴﺲ ﻓﻘﻂ ﺍﻟﺴﻼﻣﺔ ﻣﻦ ﺍﻷﻭﺭﺍﻡ ﻣﻦ ﺧﻼﻝ ﺍﻟﺠﺮﺍﺣﺔ ﺍﻟﺠﺬﺭﻳﺔ ﻭﺍﻟﺤﺪﻭﺩ ﺍﻻﻣﻨﺔ ، ﻭﻟﻜﻦ ﺃﻳﻀﺎ ﺃﻓﻀﻞ ﻧﺘﻴﺠﺔ ﺗﺠﻤﻴﻠﻴﺔ ﻭ ﺍﻧﻌﻜﺎﺳﻬﺎ ﻋﻠﻲ ﺭﺿﺎﺀ ﺍﻟﻤﺮﺿﻲ.
ﻟﻘﺪ ﺗﻄﻮﺭﺕ ﺟﺮﺍﺣﺔ ﺍﻟﺤﻔﺎﻅ ﻋﻠﻰ ﺍﻟﺜﺪﻱ ﺍﻟﺘﺠﻤﻴﻠﻴﺔ ﻟﺘﻜﻮﻥ ﻗﺎﺩﺭﺓ ﻋﻠﻰ ﺍﺳﺘﺌﺼﺎﻝ ﺍﻷﻭﺭﺍﻡ ﺍﻷﻛﺒﺮ ﻣﻊ ﺍﻟﺤﻔﺎﻅ ﻋﻠﻰ ﺍﻟﻨﺘﺎﺋﺞ ﺍﻟﺘﺠﻤﻴﻠﻴﺔ ﺍﻟﻤﺜﻠﻰ. ﺗﻢ ﻋﻼﺝ ﺳﺮﻃﺎﻧﺎﺕ ﺍﻟﺜﺪﻱ ﺍﻟﻤﺮﻛﺰﻳﺔ ﺗﻘﻠﻴﺪﻳﺎ ﻋﻦ ﻃﺮﻳﻖ ﺍﺳﺘﺌﺼﺎﻝ ﺍﻟﺜﺪﻱ ﺍﻟﺠﺬﺭﻱ ﺍﻟﻤﻌﺪﻝ، ﺑﺴﺒﺐ ﺍﺣﺘﻤﺎﻟﻴﺔ ﺗﻌﺪﺩ ﺍﻟﻤﺮﺍﻛﺰ، ﻭﺍﻟﺘﻲ ﻋﺎﺩﺓ ﻣﺎ ﺗﻜﻮﻥ ﻣﺼﺤﻮﺑﺔ ﺑﻬﺬﻩ ﺍﻷﻧﻮﺍﻉ ﻣﻦ ﺍﻷﻭﺭﺍﻡ )ﺍﻷﻭﺭﺍﻡ ﺍﻟﻤﻮﺟﻮﺩﺓ ﻓﻲ ﺍﻟﻤﺮﻛﺰ(، ﻭﺍﻟﻐﺰﻭ ﺍﻟﻤﺒﺎﺷﺮ ﻟﻠﺤﻠﻤﺔ ﻭﺍﻟﻬﺎﻟﺔ
ﺍﻟﻤﺤﻴﻄﺔ ﺑﻬﺎ، ﻣﻤﺎ ﻳﺴﺘﻠﺰﻡ ﺍﻻﺳﺘﺌﺼﺎﻝ ﺍﻟﻼﺣﻖ، ﻣﻤﺎ ﻳﺆﺩﻱ ﺇﻟﻰ ﻧﺘﺎﺋﺞ ﺗﺠﻤﻴﻠﻴﺔ ﺳﻴﺌﺔ.
ﺗﻢ ﺗﺴﺠﻴﻞ ﺃﺭﺑﻌﻴﻦ ﻣﺮﻳﻀﺔ ﻣﺼﺎﺑﺔ ﺑﺴﺮﻃﺎﻥ ﺍﻟﺜﺪﻱ ﺍﻟﻤﺮﻛﺰﻱ ﻓﻲ ﻫﺬﻩ ﺍﻟﺪﺭﺍﺳﺔ ﻣﻦ ﻣﺎﺭﺱ 2023 ﺇﻟﻰ ﻧﻮﻓﻤﺒﺮ 2024 ﻓﻲ ﻣﺴﺘﺸﻔﻴﺎﺕ ﻗﺼﺮ ﺍﻟﻌﻴﻨﻲ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ، ﻭﺗﻢ ﺗﻘﺴﻴﻤﻬﻢ ﻋﺸﻮﺍﺋﻴﺎ ﺇﻟﻰ ﻣﺠﻤﻮﻋﺘﻴﻦ ﻣﺘﺴﺎﻭﻳﺘﻴﻦ، ﺧﻀﻌﺖ 20 ﻣﺮﻳﻀﺔ ﻟﺠﺮﺍﺣﺔ ﺍﻟﺜﺪﻱ ﺍﻟﻤﺤﺎﻓﻈﺔ ﻣﻊ ﺇﻋﺎﺩﺓ ﺑﻨﺎﺀ ﺍﻷﻭﺭﺍﻡ ﺍﻟﺘﺠﻤﻴﻠﻴﺔ )ﺗﻘﻨﻴﺔ ﺟﺮﻳﺴﻮﺗﻲ( ﻭﺧﻀﻌﺖ 20 ﻣﺮﻳﻀﺔ ﻟﺘﻘﻨﻴﺔ ﺟﺮﻳﺰﻭﺗﻲ ﺍﻟﻤﻌﺪﻟﺔ )ﺗﻘﻨﻴﺔ ﺍﻟﻨﻤﻂ ﺍﻟﺤﻜﻴﻢ( )ﺗﺼﻐﻴﺮ ﺍﻟﺜﺪﻱ
ﻟﻢ ﻳﻜﻦ ﻫﻨﺎﻙ ﻓﺮﻕ ﻛﺒﻴﺮ ﺑﻴﻦ ﺍﻟﻤﺠﻤﻮﻋﺘﻴﻦ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺎﻟﺴﻼﻣﺔ ﺍﻻﻣﻨﺔ ﻟﺤﺪﻭﺩ ﺍﻟﻮﺭﻡ ﻭﻣﻌﺪﻝ ﺗﻜﺮﺍﺭ ﺍﻟﻤﺮﺽ ﻭﺍﺣﺘﻤﺎﻟﻴﺔ ﺣﺪﻭﺙ ﻣﻀﺎﻋﻔﺎﺕ ﻭﺍﻟﻨﺘﺎﺋﺞ ﺍﻟﺠﻤﺎﻟﻴﺔ، ﻭﻫﺬﺍ ﻳﺸﻴﺮ ﺇﻟﻰ ﺍﻟﻨﺠﺎﺡ ﺍﻟﻜﺒﻴﺮ ﻟﺘﻘﻨﻴﺔ ﺍﻟﻨﻤﻂ ﺍﻟﺤﻜﻴﻢ ﻟﺘﻘﺪﻳﻢ ﻧﻔﺴﻬﺎ ﻛﺨﻴﺎﺭ ﻣﻔﻴﺪ ﻟﻠﻐﺎﻳﺔ ﻓﻲ ﺍﺳﺘﺌﺼﺎﻝ ﺍﻷﻭﺭﺍﻡ ﺍﻟﺘﺠﻤﻴﻠﻴﺔ ﻷﻭﺭﺍﻡ ﺍﻟﺜﺪﻱ
ﺍﻟﻤﺮﻛﺰﻳﺔ ﻣﻘﺎﺭﻧﺔ ﺑﺘﻘﻨﻴﺔ ﺟﺮﻳﺰﻭﺗﻲ ﺍﻟﺘﻲ ﺗﻌﺘﺒﺮ ﺍﻟﻤﻌﻴﺎﺭ ﺍﻟﺬﻫﺒﻲ ﻟﻠﺤﻠﻮﻝ ﻟﻬﺬﺍ ﺍﻟﻨﻮﻉ ﻣﻦ ﺃﻭﺭﺍﻡ ﺍﻟﺜﺪﻱ
ﻳﻤﻜﻦ ﺍﺳﺘﺨﺪﺍﻡ ﺗﻘﻨﻴﺎﺕ ﻣﺘﻌﺪﺩﺓ ﻟﺠﺮﺍﺣﺔ ﺍﻟﺜﺪﻱ ﺍﻟﺘﺠﻤﻴﻠﻴﺔ ﺑﺄﻣﺎﻥ ﻻﺳﺘﺌﺼﺎﻝ ﺃﻭﺭﺍﻡ ﺍﻟﺜﺪﻱ ﺍﻟﻤﺮﻛﺰﻳﺔ ﻣﻊ ﻧﺘﺎﺋﺞ ﺗﺠﻤﻴﻠﻴﺔ ﻣﺮﺿﻴﺔ. ﻳﻌﺘﻤﺪ ﺍﺧﺘﻴﺎﺭ ﺍﻟﺘﻘﻨﻴﺔ ﺍﻟﺠﺮﺍﺣﻴﺔ ﺍﻟﻤﺜﻠﻰ ﻟﻜﻞ ﻣﺮﻳﺾ ﻋﻠﻰ ﻋﺪﺓ ﻋﻮﺍﻣﻞ، ﻣﺜﻞ
ﺣﺠﻢ ﻭ ﺩﺭﺟﺔ ﺗﺪﻟﻲ ﺍﻟﺜﺪﻱ ﻭﻣﺎ ﺇﺫﺍ ﻛﺎﻥ ﺍﻟﻮﺭﻡ ﻗﺪ ﺃﺻﺎﺏ ﺍﻟﻐﺪﺓ ﺍﻟﻠﻤﻔﺎﻭﻳﺔ ﺃﻡ ﻻ.
ﺇﻥ ﺗﺼﻐﻴﺮ ﺍﻟﺜﺪﻱ ﺑﺎﻟﺠﺮﺍﺣﺔ ﺍﻟﺘﺠﻤﻴﻠﻴﺔ ﻣﻦ ﺧﻼﻝ ﺗﻘﻨﻴﺔ ﺍﻟﻨﻤﻂ ﺍﻟﺤﻜﻴﻢ ﻟﻴﺲ ﻣﻔﻬﻮﻣﺎ ﺟﺪﻳﺪﺍ ﻭﻟﻜﻨﻪ ﺃﺻﺒﺢ ﻣﻘﺒﻮﻻ ﺑﺸﻜﻞ ﻣﺘﺰﺍﻳﺪ ﻣﻦ ﻗﺒﻞ ﺟﺮﺍﺣﻲ ﺍﻷﻭﺭﺍﻡ ﺍﻟﺜﺪﻳﻴﺔ. ﻓﻲ ﺍﻟﻤﺮﺿﻰ ﺍﻟﻤﺨﺘﺎﺭﻳﻦ، ﺳﻤﺢ ﻟﻨﺎ
ﻫﺬﺍ ﺍﻟﻨﻬﺞ ﺑﺈﺟﺮﺍﺀ ﺍﺳﺘﺌﺼﺎﻻﺕ ﻭﺍﺳﻌﺔ ﻭﺍﻟﺤﺼﻮﻝ ﻋﻠﻰ ﺳﻴﻄﺮﺓ ﺟﻴﺪﺓ ﻋﻠﻰ ﺍﻷﻭﺭﺍﻡ ﻣﻊ ﻧﺘﺎﺋﺞ ﺟﻤﺎﻟﻴﺔ ﻣﻮﺍﺗﻴﺔ. ﻛﺎﻧﺖ ﻏﺎﻟﺒﻴﺔ ﺍﻟﻤﻀﺎﻋﻔﺎﺕ ﻓﻮﺭﻳﺔ ﻭﻃﻔﻴﻔﺔ ﻭﻗﺎﺑﻠﺔ ﻟﻠﻤﻘﺎﺭﻧﺔ ﺑﺘﻘﻨﻴﺎﺕ ﺍﻟﺠﺮﺍﺣﺎﺕ ﺍﻟﺘﺠﻤﻴﻠﻴﺔ ﺍﻷﺧﺮﻯ. ﺍﻟﻤﺆﺷﺮ ﺍﻟﺮﺋﻴﺴﻲ ﻫﻮ ﻓﻲ ﺍﻟﻤﺮﺿﻰ ﺍﻟﺬﻳﻦ ﻟﺪﻳﻬﻢ ﺃﻧﺴﺠﺔ ﺛﺪﻱ ﻛﺎﻓﻴﺔ ﻹﺟﺮﺍﺀ ﺇﻋﺎﺩﺓ ﺍﻟﺒﻨﺎﺀ

Issues also as CD.

Text in English and abstract in Arabic & English.