Pedicled dermoglandular flap reconstruction following breast conserving surgery

Khafagy, Medhat; Fakhr, Ibrahim; Hamed, Alaa; Youssef, Omar

doi:10.1016/j.jnci.2012.05.001

Cited by 5 publications

(5 citation statements)

References 36 publications

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“…In addition, the scoring system in each methodology widely varied, such as 0% to 100% satisfaction, acceptable versus unacceptable, and excellent/good/satisfactory/poor 15, 29, 38, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59. The only standardization involved in methodology was the 5 parameters that were used in the cosmesis assessment: breast shape, symmetry, scars, nipple areola complex position and shape, and postirradiation sequelae 15, 29, 38, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59. The differences in the methodology diminish the possibility of establishing a meaningful comparison across studies.…”

Section: Discussionmentioning

confidence: 99%

Oncoplastic breast surgery in the setting of breast-conserving therapy: A systematic review

Yoon¹,

Green²,

Kim

et al. 2016

Advances in Radiation Oncology

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Breast-conserving therapy (BCT), or breast-conserving surgery with adjuvant radiation therapy, has become a standard treatment alternative to mastectomy for women with early-stage breast cancer after many long-term studies have reported comparable rates of overall survival and local control. Oncoplastic breast surgery in the setting of BCT consists of various techniques that allow for an excision with a wider margin and a simultaneous enhancement of cosmetic sequelae, making it an ideal breast cancer surgery. Because of the parenchymal rearrangement that is routinely involved in oncoplastic techniques, however, the targeted tissue can be relocated, thus posing a challenge to localize the tumor bed for radiation planning. The goals of this systematic review are to address the challenges, outcomes, and cosmesis of oncoplastic breast surgery in the setting of BCT.

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Section: Discussionmentioning

confidence: 99%

Oncoplastic breast surgery in the setting of breast-conserving therapy: A systematic review

Yoon¹,

Green²,

Kim

et al. 2016

Advances in Radiation Oncology

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“…In those patients, early complications affected more frequently the breast with cancer than in the healthy breast, as infection, seroma formation and wound dehiscence, due to the more complex surgical approach and the more extensive surgery (including axillary SNB or complete axillary dissection -three levels). However, local complications at the cancer site do not negatively influences delivery of adjuvant treatment as reported by most studies comparing oncoplastic versus conservation alone, showing no difference in surgical complications between the two groups [67].…”

Section: Oncoplastic Surgerymentioning

confidence: 80%

“…Among the full range of oncoplastic techniques, there are two fundamentally different approaches: volumereplacement procedures, which combine resection with immediate reconstruction by using local flaps (glandular, fasciocutaneous and latissimus dorsi miniflaps); and volume-displacement procedures, which combine resection with a variety of different breast reduction and reshaping techniques, according to the location of the tumor. Among the all choices of oncoplastic techniques, there are two fundamentally diverse approaches: volume-replacement procedures, which match resection with immediate reconstruction by using local flaps (glandular, fasciocutaneous and latissimus dorsi miniflaps); and volume-displacement procedures, which combine resection with different breast reduction and reshaping techniques, based on the site of the tumor [67]. Both approaches may be performed in case of synchronous multicentric cancers according to tumor size and location and breast size.…”

Section: Oncoplastic Surgerymentioning

confidence: 99%

Multicentric breast cancer with heterogeneous histopathology: a multidisciplinary review

et al. 2020

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Multiple synchronous (multifocal or multicentric) ipsilateral breast cancers with heterogeneous histopathology are a rare clinical occurrence, however, their incidence is increasing due to the use of MRI for breast cancer screening and staging. Some studies have demonstrated poorer clinical outcomes for this pattern of breast cancer, but there is no evidence to guide clinical practice. In this multidisciplinary review, we reflect on pathology and molecular characteristics, imaging findings, surgical management including conservation and reconstructive options and approach to the axilla, and the role of chemotherapy and radiotherapy. Multidisciplinary discussions appear decisive in planning an appropriate surgical choice and defining the correct systemic treatment tailored to each clinical condition.

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“…Zaha et al 26 noted that fat necrosis occurred in 5.2% of patients and these patients were treated conservatively. Khafagy et al 27 reported fat necrosis incidence rate of 6.67% with no seroma. Two patients (8.3%) in our study group II developed epigastric incisional hernia for whom a mesh hernioplasty was performed with complete disconnection of the omental flap that was intact and viable.…”

Section: Discussionmentioning

confidence: 98%

Comparative study between laparoscopically harvested omental flap and glandular flap in immediate reconstruction after conservative surgery in breast cancer

et al. 2021

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Aim Oncoplastic breast surgery involves reconstruction of the resection defect by either volume displacement or volume replacement. Glandular flap insertion is an easy, quick, and acceptable method to correct breast defects after breast conserving surgery (BCS). The value of the omentum in extraperitoneal reconstruction was not appreciated until the mid‐20th century. The aim of this study was to assess the aesthetic outcome after immediate breast reconstruction with either glandular flap or laparoscopic‐harvested omental flap in early breast cancer after BCS. Patients and Methods This study was conducted on 44 patients with early breast cancer in the Surgical Oncology Unit, General Surgery Department, Tanta University Hospital during the period from October 2018 to May 2019. All patients underwent breast conserving surgery followed by immediate breast reconstruction by either glandular flap (group I; 20 patients) or omentoplasty (group II; 24 patients). The operative time, postoperative complications, the length of hospital stay, and aesthetic outcome were compared between the two groups. Results The operative time in group I ranged from 90 to 120 minutes with a mean time of 113 minutes, whereas that in group II ranged from 110 to 160 minutes with a mean of 133 minutes. The hospital stay in group I ranged from 4 to 5 days with a mean of 4 days, whereas that in group II it ranged from 4 to 6 days with a mean of 5 days. In group I, two patients (10%) developed wound seroma and two patients (10%) developed fat necrosis, whereas in group II, eight patients (33.3%) developed fat necrosis and two patients (8.3%) developed epigastric incisional hernia with no wound seroma reported. Concerning the aesthetic outcome evaluated using patient's self‐evaluation, in group I, 70% of the patients were satisfied with the overall aesthetic results and 30% were dissatisfied, whereas in group II, 91.7% of the patients were satisfied and 8.3% were dissatisfied. With regard to the aesthetic outcome evaluated based on objective assessment with the Breast Cancer Conservation Treatment Cosmetic results software (BCCT.core), in group I, excellent results were obtained in 20% of cases, good results in 40% of cases, fair results in 20% of cases, and poor results in 20% of cases, whereas in group II, excellent results were obtained in 41.7% of cases, good results in 33.3% of cases, fair results in 16.7% of cases, and poor results in 8.3% of cases. No local recurrence or distant metastasis was reported. Conclusion The glandular flap has shorter operative time and requires less extensive surgery than the omental flap. The omental flap has the potential to recreate a soft, naturally ptotic breast shape that is ideal for matching with the contralateral breast.

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Pedicled dermoglandular flap reconstruction following breast conserving surgery

Abstract: Following central quadrantectomy BCS for small centrally located breast cancer, a pedicled dermoglandular flap from the upper outer quadrant is a good reconstructive option.

Cited by 5 publications

References 36 publications

Oncoplastic breast surgery in the setting of breast-conserving therapy: A systematic review

Oncoplastic breast surgery in the setting of breast-conserving therapy: A systematic review

Multicentric breast cancer with heterogeneous histopathology: a multidisciplinary review

Comparative study between laparoscopically harvested omental flap and glandular flap in immediate reconstruction after conservative surgery in breast cancer

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