Surgical strategy, methods of reconstruction, surgical margins and postoperative complications in oncoplastic breast surgery

Abstract

BackgroundOncoplastic breast surgery is an evolving discipline in the surgical treatment of breast cancer aimed to improve the outcome.MethodsOncoplastic breast surgery was performed between January 2008 and December 2010 on 72 women with 74 breast cancers selected from a population of 1,018 primary breast cancer patients. Careful preoperative planning revealed the possibility of partial breast reconstruction with volume reduction, volume displacement or volume replacement depending on breast size as well as tumour size and location. Data were registered consecutively.ResultsThe surgical plan was successful in all but one case, where a mastectomy had to be performed during the primary surgery. In 53 cases, a contralateral mammoplasty was performed during the operation to achieve symmetry. During the follow-up period until November 2011, only one patient needed corrective surgery. Final histopathological examination indicated that seven cases required extended resection and three cases required a mastectomy. Five patients experienced delayed wound healing, although complications requiring further surgery occurred for the reconstructed breast in four cases, the contralateral breast in three cases and the axilla after exaeresis in two cases because of haematoma. Such complications led to slight delay in adjuvant therapy for four patients.ConclusionsThis study demonstrates that it is feasible to implement oncoplastic breast surgery into daily clinical practice as a supplement to conventional breast cancer surgery. As such, oncoplastic breast surgery may provide a markedly better outcome than breast-conserving surgery in terms of shape and symmetry without compromising the surgical margins.Level of Evidence: Level IV, prognostic/risk study.

Patient-reported outcome after oncoplastic breast surgery compared with conventional breast-conserving surgery in breast cancer

“…Several studies have evaluated oncoplastic surgery as a concept [4,5,7,10], others have considered surgical techniques [4,10], postoperative complications [6,10,11], as well as oncological [6,11,12] and esthetical outcomes [ Patients with E-post n = 1229…”

Locoregional flaps in oncoplastic surgery and breast reconstruction

“…Starting from this premise, there is a greater tendency to treat large tumors conservatively. However, the greatest limitation is to perform large resections without compromising the cosmetic result 5,6,7 . Oncoplastic breast surgery, which consists of the combination of plastic surgery techniques and oncologically safe surgical techniques in the treatment of breast cancer, is widely accepted as the alternative that allows for greater resections and less aesthetic damage, even in voluminous tumors.…”

Tumour-adapted Reduction Mammoplasty – a New (Old) Breast Conserving Strategy: Review

“…However according to current patient survey-based studies scar length is not a decisive factor for patient satisfaction following breast surgery. Women regard the preservation of breast shape/contour and the avoidance of retractions and asymmetry as far more important [15][16][17][18][19][20]. It should be noted though that the final, definitive aesthetic and functional result can only be appreciated months after the operation after surgical wounds have healed and radiotherapy, which is often required, completed.…”