Feasibility of oncoplastic techniques in the surgical management of locally advanced breast cancer

Matthes, Ângelo Gustavo Zucca; Uemura, Gilberto; Kerr, Lígia Maria; Matthes, Ângelo Carmo Silva; Michelli, Rodrigo Augusto Depieri; Folgueira, Maria Aparecida Azevedo Koike; Viera, Rene Aloísio da Costa

doi:10.1016/j.ijsu.2012.07.009

Cited by 23 publications

(26 citation statements)

References 32 publications

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“…Skin sparing mastectomy (SSM) and/or nipple sparing mastectomy (NSM) are popular in some of the LABC cases because of advantages of better local control, esthetic and satisfaction results [13,29]. In OBCS, by the use of otology tissues for reconstruction, implant problems are avoided [29,30].…”

Section: Discussionmentioning

confidence: 99%

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The effectiveness of simultaneous oncoplastic breast surgery in patients with locally advanced breast cancer

Emiroğlu¹,

Sert²,

Karaalı³

et al. 2015

Breast Cancer

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Section: Discussionmentioning

confidence: 99%

“…Thus, this approach provides a better quality of life than applications performed at later stages [11,12]. Additionally, oncoplastic techniques can increase the rate of BCS in cases of LABC [13,14].…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of simultaneous oncoplastic breast surgery in patients with locally advanced breast cancer

Emiroğlu¹,

Sert²,

Karaalı³

et al. 2015

Breast Cancer

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“…Mathes et al [18] operated 17 patient with LABC utilizing advanced oncoplastic techniques with no positive margins, Similary Viera et al [16] reported margin length 16.44 mm by oncoplastic surgery with no positive margins, Emiroglu et al [14] found that the mean surgical margin length was 8.7 mm (range 5 -17 mm) with positive margins in 7.1% of cases, in a study done by Clough et al [21] patients who received NACT and OS had a positive margins rate 10.9%.…”

Section: Discussionmentioning

confidence: 99%

Oncoplastic Breast Surgery after Neoadjuvant Chemotherapy Replacing Mastectomy in Locally Advanced Breast Cancer (LABC): Single Institute Experience

Ghamrini¹,

Morad²,

Elsadek³

et al. 2017

JCT

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Background: Integration of neoadjuvant chemotherapy (NCT) in early 70s resulted that many LABC tumors become resectable but with total mastectomy especially those with partial response, oncoplastic techniques give better oncological outcome with better cosmetic results. Objective: We evaluate the oncological safety of oncoplastic breast surgery (OS) in LABC showing partial response to NCT. Methods: We prospectively analyzed the data of 32 out of 58 patients with LABC who showed partial response to NCT and could have conservative surgery with advanced oncoplastic techniques rather than total mastectomy. Results: Out of 58 patients with LABC, received neoadjuvant chemotherapy, complete response was observed in 8 patients (13%), partial response reported in 32 (55.1%) cases, 12 patients (20%) had stable disease and 6 patients (10%) showed progressive disease. Data of 32 cases were studied (mean age 44.84 ± 9.10 years; range 26 -59 years). Inferior pedicle was performed in 9 cases, mini LD flap in 3 patients, 5 had Grissotti technique, 6 with superomedial pedicle, 4 had V mammoplasty and 3 with J mammoplasty and 2 had vertical mammoplasty. Margins were positive in 5 cases (15.6%) with mean margin width 9.63 ± 5.72 (range 0 -22 mm), and the local recurrence was reported in 2 cases (6.2%). Complications were reported in 3 cases (9.3%). The follow up was 1.67 ± 1.03 (range 0 -3.3 years). Conclusions: Integration of neoadjuvant chemotherapy together with advanced oncoplastic techniques opens a new way for management of LABC especially those showing partial response with avoidance of total mastectomy, and comparable oncological safety in addition to better aesthetic and psychological outcome.

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“…Whether the wider margins enabled by OBS results in lower incidence of locoregional recurrence remains to be seen on a longer follow-up. Other studies with longer follow-up have indicated a recurrence rates of 6-10 % following OBS which is comparable to that of conventional BCS [20,21]. The study may be criticized on the aspect that it is not a prospective, randomized study; rather, it relies on comparing OBS with a retrospective cohort.…”

Section: Discussionmentioning

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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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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Feasibility of oncoplastic techniques in the surgical management of locally advanced breast cancer

Abstract: Oncoplastic surgical techniques for selected patients decrease the rates of radical surgery despite large tumors. (www.clinicaltrials.gov, NCT00820690).

Cited by 23 publications

References 32 publications

The effectiveness of simultaneous oncoplastic breast surgery in patients with locally advanced breast cancer

The effectiveness of simultaneous oncoplastic breast surgery in patients with locally advanced breast cancer

Oncoplastic Breast Surgery after Neoadjuvant Chemotherapy Replacing Mastectomy in Locally Advanced Breast Cancer (LABC): Single Institute Experience

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

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