An Oncoplastic Surgery Primer: Common Indications, Techniques, and Complications in Level 1 and 2 Volume Displacement Oncoplastic Surgery

Patel, Krishnabhai; Bloom, Joshua A.; Nardello, Salvatore; Cohen, Sidney; Reiland, Juliann; Chatterjee, Abhishek

doi:10.1245/s10434-019-07592-5

Cited by 37 publications

(51 citation statements)

References 30 publications

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“… ∗ At final pathology; ^largest diameter among all imaging modalities; for multifocal lesions calculated as the largest diameter including all tumor foc; °Level II oncoplastic surgery according to the definition Patel et al. [ 16 ]. …”

Section: Resultsmentioning

confidence: 99%

“… c Level II oncoplastic surgery according to the definition Patel et al. [ 16 ]. d At final pathology.…”

Section: Resultsmentioning

confidence: 99%

“…MRI: Magnetic resonance imaging; b Largest diameter among all imaging modalities, for multifocal lesions calculated as the largest diameter including all tumor foci; MX mammography; US; ultrasound scan; RX: radiography; cMacroscopic pahological evaluation only; d Level II oncoplastic surgery according to the definition of Patel et al. [ 16 ]; e Number of BCS performed per year: high >100; intermediate: 30–100; low: < 30.…”

Section: Resultsmentioning

confidence: 99%

“…In particular, large tumor size was not an absolute criterion to perform mastectomy; instead, tumor-to-breast volume ratio, tumor location within the breast, presence and distribution of microcalcifications and tumor histology (i.e ductal carcinoma in situ or invasive lobular carcinoma) were all taken into account at preoperative multidisciplinary meetings when deciding whether BCS or mastectomy was preferable. Level I oncoplastc techniques as defined by the ASBrS [ 16 ] were commonly adopted by breast surgeons, while plastic surgeons were involved for level II oncoplastic surgeries. All operations were carried out by surgeons with at least 3 years of experience in breast surgery.…”

Section: Methodsmentioning

confidence: 99%

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Reoperation rate after breast conserving surgery as quality indicator in breast cancer treatment: A reappraisal

et al. 2020

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Aim To analyse the role of repeated breast surgery (RBS) after breast conserving surgery (BCS) as a quality indicator in a consecutive series of breast cancer patients. Methods Data from 1233 breast cancer patients submitted to BCS from 2015 to 2019 were reviewed. The influence of several variables on RBS rate (182/1232; 14.8%) was examined. Univariate and multivariate analyses were conducted to look for significant associations with the risk of RBS. Results Surgical workload, BCS rate and clinicopathological variables were consistent over the study period, while RBS rate decreased after the introduction of shaving of cavity margins (from 17.9% to 9.5%). Tumor persistence at RBS was higher for mastectomy vs. re-excision (87.3% vs. 37.8%; p = 0.05), inconclusive vs. positive diagnostic biopsy (48.2% vs. 69.4%; p = 0.003), ductal carcinoma in situ vs. invasive carcinoma (69.0% vs. 51.3%; p = 0.046) and lower after neoadjuvant therapy (14.3% vs. 57.8%; p = 0.044). Several clinicopathological variables were associated with the risk of RBS, but only multifocality [Odds Ratio (OR): 1.8; p = 0.009], microcalcifications (OR: 2.0, p = 0.000), neoadjuvant therapy (OR: 0.4; p = 0.014), pathological intraoperative assessment (OR: 0.6; p = 0.010) and shaving of cavity margins (OR: 0.3; p = 0.000) retained independent value at multivariate analysis. Conclusions RBS rate can be reduced by shaving of cavity margins. Current standards for RBS should not be made more stringent due to the existence of non-actionable risk factors. The value of RBS as a quality indicator should be scrutinzed.

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Section: Resultsmentioning

confidence: 99%

“… c Level II oncoplastic surgery according to the definition Patel et al. [ 16 ]. d At final pathology.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Reoperation rate after breast conserving surgery as quality indicator in breast cancer treatment: A reappraisal

et al. 2020

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“…While breast-conserving surgery and mastectomy with reconstruction are both oncologically safe options, breast-conserving surgery is sometimes contraindicated and safe oncologic breast surgery requires mastectomy. 1 Implant-based reconstruction has been the most used technique for post-mastectomy breast reconstruction, 2 mainly in the form of submuscular or dual plane (partial submuscular) implant placement. 3 With the development of acellular dermal matrix (ADM) for soft tissue coverage, prepectoral breast reconstruction has become a more viable alternative.…”

Section: Introductionmentioning

confidence: 99%

<p>Prepectoral Breast Reconstruction: An Overview of the History, Technique, and Reported Complications</p>

Bloom¹,

Patel²,

Cohen³

et al. 2020

OAS

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Prepectoral breast reconstruction is an increasingly prevalent form of breast reconstruction. Prepectoral breast reconstruction was abandoned in the past due to various complications but has recently made a resurgence due to the development of acellular dermal matrices and innovative techniques. The purpose of this review article is to discuss the history, techniques, benefits, and potential complications of prepectoral breast reconstruction. The article also reviews current literature to evaluate published complication rates. Complications evaluated include infection (3.67%), wound dehiscence (2.10%), skin necrosis (3.67%), seroma (2.89%), hematoma (1.34%), implant loss (3.28%), return to the OR (6.15%), contracture (3.61%), and rippling (7.38%). In conclusion, prepectoral breast reconstruction is a reliable, safe, and aesthetically feasible method of breast reconstruction. With increasing interest in this technique, it is important that surgeons and patients are familiar with prepectoral reconstruction and this article aims at providing this information.

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Examining a decade of racial disparity in partial mastectomy and oncoplastic surgery

Jonczyk

Homsy

Naber

et al. 2022

Journal of Surgical Oncology

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Background and Objectives: Understanding racial disparity is crucial to addressing health equity and access to care. Our study aims to examine racial differences in breast conserving surgery (BCS) utilization rates and determine how these rates have changed over time.Methods: This retrospective cohort analysis utilized the NSQIP database to identify women diagnosed with breast cancer who underwent BCS procedures between 2008 and 2019. Racial utilization trends were analyzed using a Cochran-Armitage test and Index of Disparity analysis.Results: In the 12-year period, 202 492 women underwent a breast cancer surgery, of which 47% underwent BCS. Within the BCS subgroup, oncoplastic surgery utilization increased from 3% to 10%, leading to a declining proportion of partial mastectomies: 97% to 90.0% (both p < 0.01). The racial index of disparity for overall BCS patients decreased from 7% to 6%, remained unchanged (1%) for partial mastectomies, and significantly decreased in oncoplastics (23%-7.6%).Conclusion: BCS represents a mainstay option for early-staged breast cancer interventions, this study demonstrate promising progress in decreasing the index of disparity among races and persistent racial inequalities.

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An Oncoplastic Surgery Primer: Common Indications, Techniques, and Complications in Level 1 and 2 Volume Displacement Oncoplastic Surgery

Cited by 37 publications

References 30 publications

Reoperation rate after breast conserving surgery as quality indicator in breast cancer treatment: A reappraisal

Reoperation rate after breast conserving surgery as quality indicator in breast cancer treatment: A reappraisal

<p>Prepectoral Breast Reconstruction: An Overview of the History, Technique, and Reported Complications</p>

Examining a decade of racial disparity in partial mastectomy and oncoplastic surgery

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