Oncoplastic breast conserving surgery: Volume replacement vs. volume displacement

Noguchi, Masakuni; Yokoi-Noguchi, Miki; Ohno, Yukako; Morioka, Emi; Nakano, Yukiko; Kosaka, Takeo; Kurita, Tomoyuki

doi:10.1016/j.ejso.2016.02.248

Cited by 56 publications

(56 citation statements)

References 81 publications

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“…In the recent decades, the surgical management of breast cancer has steadily evolved from radical surgery to breast conservation. As a result, oncoplastic surgical techniques have emerged and are expanding dramatically . Oncoplastic surgery combines oncologic resection with immediate breast reconstruction using techniques derived from plastic surgery.…”

Section: Discussionmentioning

confidence: 99%

Oncoplastic breast surgery: Achieving oncological and aesthetic outcomes

Paridon

Kamali

Paul

et al. 2017

Journal of Surgical Oncology

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Section: Discussionmentioning

confidence: 99%

Oncoplastic breast surgery: Achieving oncological and aesthetic outcomes

Paridon

Kamali

Paul

et al. 2017

Journal of Surgical Oncology

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“…function to 100 = no function for the DASH total score; the higher the score, the greater the disability. 12 Cutoff scores in previous studies were used: no disability (0), minimal disability (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20), mild disability (21-40), moderate disability (41-60), severe disability (61-80), and very severe disability (81-100). 13,14 The Chinese version of this questionnaire was used in our study, of which the reliability and validity for upper limb function assessment has been proven and validated.…”

Section: Patientsmentioning

confidence: 99%

“…To address this issue, oncoplastic BCS emerged, extending the role of BCS where there is a paradox between adequate local excision and esthetics . For small breasts or those with small breast‐to‐tumor ratios, volume replacement is often necessary after wide excision …”

Section: Introductionmentioning

confidence: 99%

Pedicled descending branch latissimus dorsi mini‐flap in repairing partial mastectomy defect: Shoulder functional and esthetic outcomes

Zhou

Wang

Cai

et al. 2019

Journal of Surgical Oncology

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Background The axillary‐approach pedicled descending branch latissimus dorsi (LD) mini‐flap presents clear benefits in repairing partial mastectomy defects. This study assessed the functional and esthetic outcomes of this flap compared with conventional breast‐conserving surgery (BCS). Methods From October of 2015 to March of 2017, patients with early breast cancer were enrolled and assigned to the LD group or conventional BCS (CCS) group according to the need of using the pedicled descending branch LD mini‐flap for volume replacement. Muscle strength and range of motion (ROMs) of bilateral shoulders, a disabilities of the arm, shoulder and hand (DASH) questionnaire, and an esthetic evaluation were conducted in all patients at 1 year after surgery. Results Thirty‐two patients were assigned in the LD group, and 28 in the CCS group. There was no significant difference in muscle strength, ROMs of the shoulder or DASH scores between LD and CCS groups. The results of esthetic survey also revealed a similarly high level of esthetics in both groups. Donor‐site seroma occurred in three patients in the LD group, and no other complication was observed. Conclusions The pedicled descending branch LD mini‐flap enabled larger excision with favorable esthetics, minimal functional impairment, low rate of complications, and high level of satisfaction.

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“…Increasing disease free survival rates drew attention to the cosmetic results of breast conserving surgery. Compared with standard quadrantectomy or lumpectomy, oncoplastic surgery (ONC) achieves more accurate tumour resection and free resection margins with better cosmesis (23). Oncoplastic surgery may be personalized for patients with breast cancer by allowing partial mastectomy with good cosmesis, and can decrease total mastectomy or subcutaneous mastectomy with prosthetic reconstruction in many patients without increasing local recurrence, and has fewer complications than mastectomies.…”

Section: Personalized Surgerymentioning

confidence: 99%

Paradigm Shift From Halstedian Radical Mastectomy to Personalized Medicine

Özmen¹

2017

J Breasth Health

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The paradigm shift in breast cancer biology has changed the management of breast cancer from radical mastectomy to precision medicine. In the late 19 th century, William Steward Halsted thought that breast cancer was a local-regional disease, and he proposed radical mastectomy, which became the standard surgical treatment of breast cancer for nearly 100 years (1). Halsted succeeded in decreasing the locoregional recurrence rate to 6% at 5 years in contrast to his European counterparts, whose local recurrence rates ranged from 50 to 80% (2). Despite the decrease in local recurrence rate, radical mastectomy did not improve survival rate in comparison to lesser surgical procedures. Bernard Fisher's alternative paradigm championed an emergence of breast cancer as a systemic disease in 1970s (3-4). He considered that breast cancer was a systemic disease at the outset as a consequence of cells entering lymphatics, but also into the blood via communications. According to this hypothesis, systemic treatment became a substantial part of breast cancer management, and multidisciplinary approaches were required for a more effective treatment. Prospective randomized clinical studies of the 1970s and 1980s (NSABP B04, NSABP B06, MILAN I study, etc.) supported Fisher's hypothesis -variations in the extent of local therapy such as simple mastectomy, quadrantectomy or wide tumour excision plus whole-breast radiation therapy yielded no significant differences in survival outcomes (5-7). Both Halstedian and Fisherian Hypotheses recommended one treatment protocol (radical mastectomy or systemic treatment±radiation therapy) to all patients with breast cancer (one size fits all). Since these two old hypotheses did not separate low-risk patients from highrisk patients, overtreatment was a major problem for patients with low-risk breast cancer. Today, we accept the intermediate paradigm that is combination of Halstedian and Fisherian hypotheses. Rising breast cancer awareness and mammographic screening have increased early-stage breast cancer and ductal carcinoma in situ rates. Almost half of these patients have good prognostic factors and do not require systemic treatment and/or radiation therapy. Patients diagnosed via screening mammography have better prognostic factors than symptomatic breast cancer patients. Systemic treatment and radiation therapy have very harmful side effects despite of their life saving benefits (8). They are also expensive and impose an economic burden on the health care system (9). Paradigm Shift From Halstedian Radical Mastectomy to Personalized MedicineVahit Özmen Department of General Surgery, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey J Breast Health 2017; 13: 50-53 DOI: 10.5152/tjbh.2017.312017 ABSTRACT Breast cancer management changed from radical mastectomy to precision medicine in a period longer than a century. The aims of these changes were to refrain from overdiagnoses and overtreatments as well as their harmful side effects and extra costs. Breast cancer is a heterogen...

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Oncoplastic breast conserving surgery: Volume replacement vs. volume displacement

Cited by 56 publications

References 81 publications

Oncoplastic breast surgery: Achieving oncological and aesthetic outcomes

Oncoplastic breast surgery: Achieving oncological and aesthetic outcomes

Pedicled descending branch latissimus dorsi mini‐flap in repairing partial mastectomy defect: Shoulder functional and esthetic outcomes

Paradigm Shift From Halstedian Radical Mastectomy to Personalized Medicine

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