Breast conserving oncoplastic surgery in the treatment of centrally located malignant breast tumors

Abstract

Central breast neoplasms account for 5 to 20% of breast cancer cases. For decades, they have been traditionally treated with mastectomy. The high incidence of involvement associated with these tumors necessitates nipple and areola resection. Oncoplastic surgical techniques, in well selected cases, enable the achievement of adequate cosmetic results following a radical central quadrantectomy along with the Nipple-Areola Complex. The present paper summarizes the indications, techniques and results of breast conserving surgeries of central breast tumors.

Modern Breast Cancer Surgery 1st Central-Eastern European Professional Consensus Statement on Breast Cancer

“…This is a breast cancer with one of the worst biological behaviours. Its clinical appearance is explained by tumour invasion of the lymphatic vessels of the skin (breast swelling, marked oedema, erythema, peau d’orange), which mimics an inflammatory disease (T4d) ( 21 ).…”

“…Gene testing can only be performed in accordance with strict professional standards in accredited laboratories. BRCA1/2 mutation carriers or other mutations holders with high penetrant genes (see above) should also be informed and various therapeutic options (such as close follow-up, oncopsychological guidance, lifestyle counselling, family screening, reproductive counselling, chemoprevention, and prophylactic mastectomy) should be discussed only in specialized centres with adequate knowledge and experience ( 21 ). During genetic testing, BRCA mutations are most commonly examined; however, if these are not present and if there is significant family history, other less common genetic disorders should also be considered (Li-Fraumeni syndrome: p53 mutation; Cowden’s syndrome: PTEN mutation; ATM mutation; Lynch-syndrome: MLH1 , MSH2 , MSH6 , EPCAM , PMS2 mutation, RAD51 mutation, BRIP1 mutation, PALB2 mutation, CHEK2 mutation, Peutz-Jeghers syndrome: STK11 mutation, CDH1 mutation).…”

“…In a significant proportion of breast cancer patients, complete breast removal is still required for proper oncological surgical care ( 11 , 21 , 23 , 62 ). Breast reconstruction is also provided for female patients who have undergone mastectomy.…”