Oncoplastic Repair in Breast Conservation: Comprehensive Evaluation of Techniques and Oncologic Outcomes of 937 Patients

Kaviani, Ahmad; Tabary, Mohammadreza; Zand, Sanaz; Araghi, Farnaz; Patocskai, Érica; Nouraie, Mehdi

doi:10.1016/j.clbc.2020.05.016

Cited by 5 publications

(3 citation statements)

References 37 publications

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“…3 Kaviani et al reported the recurrence rate of 5.4% over a follow-up period of 26.4 months among nine hundred and thirty seven patients who underwent BCS via different approaches including RBT. 15 In our study, there were 18 carcinoma cases and 2 DCIS operated by RBT. Four patients had positive margins but re-excision was not required as the cavity margin shavings taken at the time of the first surgery as per institution protocol were negative given their oncological safety.…”

Section: Discussionmentioning

confidence: 64%

Single Center Experience of Round Block Technique for Breast Surgery; Oncologic Safety and Patient Satisfaction

Niaz,

Somroo,

Tariq

2024

Arch Breast Cancer

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Background: Round block technique (RBT) is a versatile technique for the excision of benign and malignant breast lesions with oncologic safety. Although a technically challenging procedure, it has the benefit of an inconspicuous scar and desirable aesthetic outcomes and wider exposure for tissue resection and remodelling. This study discusses the utility of RBT for the excision of different pathologies, complications, and cosmetic outcomes as it is underutilized in the developing countries. Methods: The study was conducted at the breast surgery clinic, at Liaquat National Hospital. All patients with benign (fibroadenomas, benign phyllodes) or malignant (carcinoma, malignant phyllodes) lesions undergoing the round block technique were included. The clinical size, site, distance from the nipple, pathology, pathological size, and margin status were recorded. Early and late complications were documented during the follow-up. At the time of the final study analysis, patients were interviewed for cosmetic outcome satisfaction using the Harvard scale (4-point Likert score) Results: Overall, 49 patients were included in the study over 2.5 years. The mean clinical tumor size was 4.72cm, of which 63% were in the upper quadrant, and the average distance from the areolar margin was 1.71cm. The pathology included 21 fibroadenomas and 18 carcinomas, with the mean size of 4.14cm. Early complications were seen in 12 cases, and late complications were observed in 2 cases which were all managed conservatively. The cosmetic outcome was found to be fair by 6.1% of the patients, good by 87%, and excellent by the 6.1% of them. Conclusion: RBT is a technically challenging procedure but is easily adaptable. It provides good exposure for excision of both benign and malignant tumors of the breast while maintaining the oncologic safety margin and good cosmesis, especially for young patients with large lesion in the upper inner quadrant.

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Section: Discussionmentioning

confidence: 64%

Single Center Experience of Round Block Technique for Breast Surgery; Oncologic Safety and Patient Satisfaction

Niaz,

Somroo,

Tariq

2024

Arch Breast Cancer

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“…In 27 studies (36.0 per cent) 31 , 40 , 42 , 65 , 66 , 68 , 73 , 85 , 86 , 88 , 90 , 93–108 , subjective aesthetic outcome assessment utilized two-dimensional digital patient photographs, where specified. In four studies 74 , 95 , 109 , 110 , patients were questioned ‘informally’, or the methodology was unclear. Only 19 studies used previously validated or published assessment tools 42 , 45 , 47 , 54 , 63 , 73 , 81 , 90 , 92–94 , 97 , 98 , 111–116 .…”

Section: Resultsmentioning

confidence: 99%

“…Aesthetic outcome was assessed by the patient and clinician ( n = 25, 33.3 per cent) 31 , 36 , 38 , 40 , 42 , 45 , 58 , 65 , 66 , 70 , 76 , 88 , 91–93 , 102 , 103 , 108 , 111 , 112 , 116 , 118–121 , clinician only ( n = 25, 33.3 per cent) 39 , 63 , 68 , 73 , 78 , 79 , 81 , 85 , 96 , 97 , 99–101 , 107 , 113 , 122–126 , patient only ( n = 22, 29.3 per cent) 2 , 47 , 49 , 54 , 64 , 67 , 72 , 74 , 89 , 94 , 109 , 110 , 114 , 117 , 127–135 or was unclear ( n = 2, 2.7 per cent) 95 , 136 . Very few studies ( n = 4) included non-medical staff in aesthetic rating panels …”

Section: Resultsmentioning

confidence: 99%

Outcome reporting in therapeutic mammaplasty: a systematic review

et al. 2021

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Background Therapeutic mammaplasty (TM) is an oncological procedure which combines tumour resection with breast reduction and mastopexy techniques. Previous systematic reviews have demonstrated the oncological safety of TM but reporting of critically important outcomes, such as quality of life, aesthetic and functional outcomes, are limited, piecemeal or inconsistent. This systematic review aimed to identify all outcomes reported in clinical studies of TM to facilitate development of a core outcome set. Methods Medline, EMBASE, CINAHL and Web of Science were searched from inception to 5 August 2020. Included studies reported clinical outcomes following TM for adult women. Two authors screened articles independently for eligibility. Data were extracted regarding the outcome definition and classification type (for example, oncological, quality of life, etc.), time of outcome reporting and measurement tools. Results Of 5709 de-duplicated records, 148 were included in the narrative synthesis. The majority of studies (n = 102, 68.9 per cent) reported measures of survival and/or recurrence; approximately three-quarters (n = 75, 73.5 per cent) had less than 5 years follow-up. Aesthetic outcome was reported in half of studies (n = 75, 50.7 per cent) using mainly subjective, non-validated measurement tools. The time point at which aesthetic assessment was conducted was highly variable, and only defined in 48 (64.0 per cent) studies and none included a preoperative baseline for comparison. Few studies reported quality of life (n = 30, 20.3 per cent), functional outcomes (n = 5, 3.4 per cent) or resource use (n = 28, 18.9 per cent). Conclusion Given the oncological equivalence of TM and mastectomy, treatment decisions are often driven by aesthetic and functional outcomes, which are infrequently and inconsistently reported with non-validated measurement tools.

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Three-dimensional surgical margin positioning technique versus palpation-guided method for breast-conserving surgery: Feasibility, advantages, and quality of life

Zhang,

Gao

et al. 2024

Asian Journal of Surgery

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Oncoplastic Repair in Breast Conservation: Comprehensive Evaluation of Techniques and Oncologic Outcomes of 937 Patients

Cited by 5 publications

References 37 publications

Single Center Experience of Round Block Technique for Breast Surgery; Oncologic Safety and Patient Satisfaction

Single Center Experience of Round Block Technique for Breast Surgery; Oncologic Safety and Patient Satisfaction

Outcome reporting in therapeutic mammaplasty: a systematic review

Three-dimensional surgical margin positioning technique versus palpation-guided method for breast-conserving surgery: Feasibility, advantages, and quality of life

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