Comparative Study of Surgical Margins in Oncoplastic Surgery and Quadrantectomy in Breast Cancer

Kaur, Navneet; Petit, Jean Yves; Rietjens, Mario; Maffini, Fausto; Luini, Alberto; Gatti, Giovanna; Rey, Piercarlo; Úrban, Cícero; Lorenzi, Francesca De

doi:10.1245/aso.2005.12.046

Cited by 253 publications

(133 citation statements)

References 34 publications

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“…In this study, it is seen that OBS resulted in larger specimen volume size as well as wider mean margins being obtained. This is similar to the experience of other authors too [6][7][8]. In our patients, total excision was made possible by tattooing the tumor skin projection preoperatively as suggested by Mathieu et al [14].…”

Section: Discussionsupporting

confidence: 88%

“…Studies have demonstrated that in early breast cancers and large operable breast cancers, as compared to conventional breast conservation surgery (wide local excision or lumpectomy with a gross margin of 1 cm plus axillary lymph node dissection), OBS achieves wider excision of tumor, superior mean volume of specimen, and potentially reduces margin involvement. It is more effective from aesthetic-functional point of view and does not compromise local control and survival [6][7][8]. Locally advanced breast cancer (LABC) accounts for a large proportion of breast cancers in India; 40-60 % in some series.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Surgical Outcomes of Oncoplasty Breast Surgery in Locally Advanced Breast Cancer and Comparison with Conventional Breast Conservation Surgery

Chauhan

Sharma

Kumar

2016

Indian J Surg Oncol

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The purpose of this study was to compare early oncologic outcomes of oncoplastic breast surgery and conventional breast conservation surgery in patients of locally advanced breast cancer. A single-center, prospective, nonrandomized study enrolled select cases of locally advanced breast cancer (TNM T3/T4, N0/1/2) who after neoadjuvant chemotherapy, were considered for breast conservation surgery with oncoplasty techniques. The specimen volume resected, the mean margins and mean closest margin obtained were noted. The re-surgery rates, complication rates, and incidence of locoregional recurrence were also noted. Variables were compared with a retrospective cohort of similar patients who had undergone conventional breast conservation surgery. Fifty-seven patients underwent OBS (group 1) and were compared with 43 cases that had undergone conventional BCS (group 2). Majority of the patients in group 1 (73 %) had cT3 with N0 or N+ and a minority (17 %) were with limited skin involvement (cT4 and N0/N+). Relatively larger sized, post-NACT tumors could undergo OBS(4.4 vs 2.3 cm). Relatively greater proportion of tumors in central and lower quadrants were addressed by oncoplasty than traditional BCS (17/57, 29 % vs 4/43, 9 %, p = 0.04). The mean specimen volume excised in group 1 was more than that in group 2. (187.54 vs 125.19; p = 0.01). The mean of the margins were obtained more in group 1 (1.04 vs 0.69 cm); p < 0.01) as also the mean closest margin (0.86 vs 0.49 cm; p < 0.01). The incidence of close or involved margins was lesser in the OBS group (8 vs 24 %). Overall incidence of complications was similar in both groups (8/57, 14 % vs 4/43, 9 %; p = 0.34 NS). The median follow-up period of group 1 is 18 months (range 06-30 months) while group 2 is 34 months (14-44 months. There was no recurrence in group 1, but there were 5 cases (11 %) in group 2. Oncoplasty breast surgery offers more opportunity for breast conservation and oncologic safety than conventional breast conserving surgery.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Evaluation of Surgical Outcomes of Oncoplasty Breast Surgery in Locally Advanced Breast Cancer and Comparison with Conventional Breast Conservation Surgery

Chauhan

Sharma

Kumar

2016

Indian J Surg Oncol

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“…Kaur et al (30) evaluated 60 patients with breast cancer in 2 groups of oncoplastic surgery and conventional surgery. In the oncoplastic surgery and conventional surgery groups, 80.4% and 56.7% of the cases had negative margin, respectively (P = 0.05).…”

Section: Discussionmentioning

confidence: 99%

“…U n c o r r e c t e d P r o o f conventional surgery since more size of tissue with higher margin can be removed by this method and it reduces the risk of positive margin (30). The main objective of this study was to compare surgical margin after breast cancer surgery between oncoplastic technique and conventional breast-conserving surgery.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Surgical Margin After Breast Cancer Surgery Between Oncoplastic Technique and Conventional Breast-Conserving Surgery

et al. 2018

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Background: Compared to other breast surgery methods, the accurate determination of pathologic margin in oncoplastic technique can affect its development and further employment of this technique. The current study aimed at evaluating positive pathologic margin after oncoplastic surgery and comparing it to that of the conventional breast-conserving surgery. Methods: The current cross sectional and prospective study enrolled patients with breast cancer referring to the surgical clinic of Tehran Cancer Institute from 2010 to 2013. In this study, patients with breast cancer were evaluated based on the type of surgery (oncoplastic or conventional breast-conserving) they had undergone. Accordingly, the positive or negative result of the margin surgery was compared between the groups. Results: In the current study, 317 patients with breast cancer underwent the surgery during the study period (154 patients in the oncoplastic and 163 patients in the conventional breast-conserving surgery groups). The highest frequency in the oncoplastic surgery belonged to Omega method (27.3%). The pathological evaluations after surgery showed ductal breast carcinoma in most of the cases in both groups (oncoplastic surgery = 94.2%; conventional breast-conserving surgery = 90.8%; P = 0.053). Positive margin in oncoplastic surgery and conventional breast-conserving surgery groups were 10.4% and 18.4%, respectively (P = 0.043). Among the 317 studied subjects, 14 relapse cases were observed; in 7 cases, mastectomy and in the rest, re-excision were conducted. Two out of 14 cases belonged to the positive margin group. Conclusions: Using oncoplastic surgery as a method for breast surgery may play an important role in reducing the prevalence of positive margins compared to the conventional breast-conserving surgery.

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“…Methods of BCS are classified into two groups as follows: Volume displacement using glandular transposition and volume replacement using autologous tissue (9,34,35). The method applied should be chosen based on the size of the defect and the breast.…”

Section: Discussionmentioning

confidence: 99%

Application of a rhomboid flap for the coverage of defects after malignant breast tumor resection: A case report

et al. 2017

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Abstract. Resection for locally advanced breast cancer (LABC) or malignant phyllodes tumors may cause a large skin defect with bone exposure. Although skin grafts are frequently used to cover such defects, they can result in poor cosmetic outcomes and graft acceptance is dependent upon the condition of the recipient site. To overcome the limitations of skin grafts, various flaps have been developed to cover such defects. The present study used a rhomboid flap for the coverage of skin defects after mastectomy and breast-conservative surgery (BCS). A total of 11 patients with malignant breast cancer underwent reconstructive surgery using the rhomboid flap between September 2011 and December 2013 (mastectomy, 9 patients; BCS, 2 patients). Skin resection size, axillary lymph node dissection, bone exposure, length of surgery, wound complications and whether preoperative/postoperative adjuvant therapy was received were analyzed. The maximum size of skin defect covered with the rhomboid flap in the present study was 20x20 cm. There were no major wound complications and all patients underwent postoperative adjuvant therapy on schedule. During BCS, a portion of the flap was used for augmentation of the breast, in addition to coverage of the skin defect, which resulted in good cosmetic outcomes. The rhomboid flap can be quickly and easily fashioned, and it does not require any special instruments.

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Comparative Study of Surgical Margins in Oncoplastic Surgery and Quadrantectomy in Breast Cancer

Cited by 253 publications

References 34 publications

Evaluation of Surgical Outcomes of Oncoplasty Breast Surgery in Locally Advanced Breast Cancer and Comparison with Conventional Breast Conservation Surgery

Evaluation of Surgical Outcomes of Oncoplasty Breast Surgery in Locally Advanced Breast Cancer and Comparison with Conventional Breast Conservation Surgery

Comparison of Surgical Margin After Breast Cancer Surgery Between Oncoplastic Technique and Conventional Breast-Conserving Surgery

Application of a rhomboid flap for the coverage of defects after malignant breast tumor resection: A case report

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