Reconstruction in Breast Conservation Therapy—Single Tertiary Care Institution Experience with 472 Patients

Abstract

Breast conservation therapy (BCT) is now internationally accepted treatment for early breast cancer. Despite of high incidence of carcinoma breast in India, BCT rates are very low as compared to the west. In this article, we wish to share our experience of breast conservation with oncoplasty in Indian women. A retrospective analysis of case records of patients treated with oncoplastic breast conservation from January 2009 to June 2014 in a single surgical oncology unit in a tertiary cancer institute. Demographic patient data, stage of disease, location of primary tumour, use of neo-adjuvant chemotherapy if received, tumour size and breast size ratio, reconstruction method used, post-operative complications and aesthetic score of patients were analysed. Various methods of oncoplasty and partial breast reconstruction used are discussed. Four hundred and seventy-two patient records were found suitable for analysis. Most common stage of presentation was T2N0 in 189 patients (40%). Forty-one patients received neo-adjuvant chemotherapy (NACT). Tumour arising in upper outer quadrant was most common site, seen in 268 (56.7%). The most common method of reconstruction was volume displacement, done in 57.6% patients. Overall surgical complications included wound infection with or without dehiscence, seroma formation, partial flap necrosis and fat necrosis. Cosmesis was found to be excellent in 23.09% and good in 58.47% at 6-month follow-up. Breast conservation with oncoplasty is oncologically safe for early breast cancer treatment and has good cosmetic outcome with high patient satisfaction rates. Its practice should be encouraged in Indian setup also.

Rates of breast reconstruction uptake and attitudes toward breast cancer and survivorship among south asians: A literature review

“…52% 21 to 77% 18 of women underwent mastectomies, whereas only 23% 18 −48% 21 underwent breast‐conserving surgery. In Western countries, BCS rates are 60%−70% 33 . Rates of breast reconstruction following mastectomy varied between 0% 23 and 14.1%., 18 with rates highest in India (14.1%) 18 than other South Asian countries including Pakistan (3.5%) 19 and Sri Lanka (1.2%) 20 .…”

“…Western countries, BCS rates are 60%−70%. 33 Rates of breast reconstruction following mastectomy varied between 0% 23 and 14.1%., 18 with rates highest in India (14.1%) 18 than other South…”

Outcome reporting in therapeutic mammaplasty: a systematic review

“…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 …”

“…Very few studies ( n = 4) included non-medical staff in aesthetic rating panels 63 , 73 , 86 , 108 . Where clinicians assessed aesthetic outcome, they were stated explicitly to be independent of care provision in 14 of 50 studies 31 , 42 , 45 , 76 , 97 , 99 , 100 , 106 , 112 , 113 , 115 , 116 , 122 , 123 . Similarly, few studies assessed correlation between aesthetic evaluation by clinicians and/or patient satisfaction and/or BCCT.core software 40 , 45 , 85 .…”