Surgical Techniques for Personalized Oncoplastic Surgery in Breast Cancer Patients with Small- to Moderate-Sized Breasts (Part 1): Volume Displacement

Yang, Jung Dug; Lee, Jeong Woo; Cho, Young Kyoo; Kim, Wan Wook; Hwang, Seung-Hyun; Jung, Jin Hyang; Park, Ho Yong

doi:10.4048/jbc.2012.15.1.1

Cited by 53 publications

(39 citation statements)

References 8 publications

(12 reference statements)

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“…It represents the major advance in the conservative treatment of breast cancer in the last decades 3 . Studies have shown a higher satisfaction rate with aesthetic result when using oncoplastic techniques, indenpendently of the extent of resected breast volume tissue 12 .…”

Section: Discussionmentioning

confidence: 99%

Locoregional flaps in oncoplastic surgery and breast reconstruction

Figueiredo¹,

Pires²,

Mendonça³

et al. 2017

Rev. Bras. Mastol. (Impr.)

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Introduction: Conserving surgery in the treatment of breast cancer, in association with radiotherapy, has replaced mastectomy in most cases. However, depending on the location and size of tumor, the classic conservative surgery can present unfavourable aesthetic results and high levels of commitment of the surgical margins. The oncoplastic breast surgery can have high local control rates and cause minimum breast deformities, leading to a better aesthetic result. Objective: To report cases of 30 patients with primary unilateral breast carcinoma who underwent oncoplastic surgery between 2013 and 2015. Methods: We used local and regional dermo-glandular rotation techniques. The average age of patients was 58.9 years. The average tumor size was 2.53 cm. Three patients had close or positive surgical margins and underwent a new surgical procedure. Results: The aesthetic result was evaluated by the BCCT.core program and was considered excellent in 11 cases, good in 12 cases and regular in 7 cases. Six patients had postoperative complications. Conclusion: The use of local and regional dermo-glandular rotation techniques allows extensive resections in breast conserving surgery, leading to a satisfying symmetry and a good aesthetic result without the need of symmetrization, with low postoperative complication rates and high rates of free surgical margins.KEYWORDS: Breast cancer; breast reconstruction; surgical flaps; surgical margins; cosmetic techniques. ABSTRACT RESUMOIntrodução: A cirurgia conservadora no tratamento do câncer de mama, associada à radioterapia, tem substituído a mastectomia na maioria dos casos. Entretanto, dependendo da localização e do tamanho do tumor, a cirurgia conservadora clássica pode resultar em um resultado estético insatisfatório e em altos índices de comprometimento de margens cirúrgicas. A cirurgia oncoplástica da mama pode apresentar altas taxas de controle local, causando deformidades mamárias mínimas, levando a um melhor resultado estético. Objetivo: Relatar casos de 30 pacientes com carcinoma mamário unilateral que foram submetidas à cirurgia oncoplástica da mama entre 2013 e 2015. Métodos: Foram utilizadas técnicas de rotação dermoglandular local e regional. A idade média das pacientes foi de 58,9 anos. O tamanho médio do tumor foi 2,53 cm. Três pacientes apresentaram margens cirúrgicas exíguas ou comprometidas, sendo submetidas a novo procedimento cirúrgico. Resultados: O resultado estético foi avaliado pelo programa BCCT.core, sendo considerado excelente em 11 casos, bom em 12 casos e regular em 7 casos. Seis pacientes apresentaram complicações pós-operatórias. Conclusão: A utilização de técnicas de rotação dermoglandular local e regional permite ressecções extensas na cirurgia conservadora da mama, permitindo uma simetria satisfatória e um bom resultado estético sem a necessidade de simetrização, com baixos índices de complicação pós-operatória e altas taxas de margens cirúrgicas livres.

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Section: Discussionmentioning

confidence: 99%

Locoregional flaps in oncoplastic surgery and breast reconstruction

Figueiredo¹,

Pires²,

Mendonça³

et al. 2017

Rev. Bras. Mastol. (Impr.)

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“…Postoperative Approach; It has been reported that OBS does not influence the selection and timing of postoperative adjuvant therapy (41,70,71). It was demonstrated that complications in patients with oncoplastic reduction or volume expansion did not delay adjuvant treatment (70,71,72).…”

Section: Oncologic and Esthetic Evaluationmentioning

confidence: 99%

“…It was demonstrated that complications in patients with oncoplastic reduction or volume expansion did not delay adjuvant treatment (70,71,72). In a similar group of patients, there are publications stating that serious complications such as flap nutritional problems resulted in a few weeks of delay in adjuvant treatment (55,73).…”

Section: Oncologic and Esthetic Evaluationmentioning

confidence: 99%

The Role of Oncoplastic Breast Surgery in Breast Cancer Treatment

Emiroğlu¹,

Sert²,

Inal

2015

J Breasth Health

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The aim of this study is to discuss indications, advantages, disadvantages, oncologic and aesthetic results of Oncoplastic Surgery (OBS). Pubmed and Medline database were searched for articles published between 1998 and 2014 for keywords: oncoplastic breast surgery, therapeutic mammoplasty, oncoplastic breast reduction, synchrenous reconstructions. Role of OBS in breast cancer surgery, its aspects to be considered, its value and results have been interpreted. This technique has advantages by providing more extensive tumourectomy, yielding better aesthetic results compared with breast conserving surgery, allowing oncoplastic reduction in breast cancer patients with macromastia, with higher patient satisfaction and quality of life and by being inexpensive due to single session practice. As for its disadvantages are: re-excision is more difficult, risk for mastectomy is higher, it is depent on the Surgeron's experience, it has a risk for delay in adjuvant therapies and its requirement for additional imaging studies during management. Main indications are patients with small tumour / breast volume, macromastia, multifocality, procedures which can disrupt breast cosmesis such as surgeries for upper inner breas tquadrient tumours. Contraindications are positive margin problems after wide excision, diffuse malign microcalsifications, inflammatory breast cancer, history of radiotherapy and patients' preferences. Despite low evidence level, Oncoplastic Breast Surgery seems to be both reliable and acceptable in terms of oncologic and aesthetic aspects. Oncoplastic Breast Surgery increase the application rate of breast conserving surgery by obviating practical limitations and improve the results of breast conserving surgery. Correct patient and technique choice in OBS is vital for optimization of post surgical

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“…Nevertheless, oncoplastic techniques that have evolved in the past decade are increasingly being incorporated into WLE to allow more extensive resections and to achieve a superior cosmetic outcome. 6,7 Such techniques can involve extensive mobilization of the breast plates to reshape the breast, and can even involve volume replacement with autologous tissue flaps, and are often not suitable as ambulatory procedures. Newer modalities, such as intraoperative radiotherapy following WLE for low-risk cancers, however, have been associated with minimal morbidity and do not compromise the suitability for ambulatory surgery.…”

Section: Introductionmentioning

confidence: 99%

Ambulatory surgery for the patient with breast cancer: current perspectives

Pek¹,

Tey²,

Tan³

2016

OAS

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Ambulatory breast cancer surgery is well accepted and is the standard of care at many tertiary centers. Rather than being hospitalized after surgery, patients are discharged on the day of surgery or within 23 hours. Such early discharge does not adversely affect patient outcomes and has the added benefits of better psychological adjustment for the patient, economic savings, and a more efficient utilization of health care resources. The minimal care needed post-discharge also means that the caregiver is not unduly burdened. Unplanned conversions to inpatient admission and readmission rates are low. Wound complications are infrequent and no issues with drain care have been reported. Because the period of postoperative observation is short and monitoring is not as intensive, ambulatory surgery is only suitable for low-risk procedures such as breast cancer surgery and in patients without serious comorbidities, where the likelihood of major perioperative events is low. Optimal management of pain, nausea, and vomiting is essential to ensure a quick recovery and return to normal function. Regional anesthesia such as the thoracic paravertebral block has been employed to improve pain control during the surgery and in the immediate postoperative period. The block provides excellent pain relief and reduces the need for opiates, which also consequently reduces the incidence of nausea and vomiting. The increasing popularity of total intravenous anesthesia with propofol has also helped reduce the incidence of nausea and vomiting in the postoperative period. Ambulatory surgery can be safely carried out in centers where there is a well-designed workflow to ensure proper patient selection, counseling, and education, and where patients and caregivers have easy access to medical services should problems arise after discharge.

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Surgical Techniques for Personalized Oncoplastic Surgery in Breast Cancer Patients with Small- to Moderate-Sized Breasts (Part 1): Volume Displacement

Cited by 53 publications

References 8 publications

Locoregional flaps in oncoplastic surgery and breast reconstruction

Locoregional flaps in oncoplastic surgery and breast reconstruction

The Role of Oncoplastic Breast Surgery in Breast Cancer Treatment

Ambulatory surgery for the patient with breast cancer: current perspectives

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