scholarly journals Oncoplastic Approaches to Breast Conservation

2011 ◽  
Vol 2011 ◽  
pp. 1-16 ◽  
Author(s):  
Dennis R. Holmes ◽  
Wesley Schooler ◽  
Robina Smith

When a woman is diagnosed with breast cancer many aspects of her physical, emotional, and sexual wholeness are threatened. The quickly expanding field of oncoplastic breast surgery aims to enhance the physician commitment to restore the patient's image and self-assurance. By combining a multidisciplinary approach to diagnosis and treatment with oncoplastic surgery, successful results in the eyes of the patient and physician are significantly more likely to occur. As a way to aid oncoplastic teams in determining which approach is most suitable for their patient's tumor size, tumor location, body habitus, and desired cosmetic outcome we present a review of several oncoplastic surgical approaches. For resections located anywhere in the breast, theradial ellipse segmentectomy incisionandcircumareolar approach for segmental resectionare discussed. For resections in the upper or central breast,crescent mastopexy, thebatwing incision, thehemibatwing incision,donut mastopexy,B-flap resection, and thecentral quadrantectomyare reviewed. For lesions of the lower breast, thetriangle incision,inframammary incision, andreduction mastopexyare discussed. Surgeons who are interested in adding oncoplastic breast conserving therapies to their skill sets are encouraged to implement these surgical techniques where applicable and to seek out breast fellowships or enhanced training when appropriate.

2020 ◽  
Vol 2020 (9) ◽  
Author(s):  
Miguel Johnson ◽  
Lorna Cook ◽  
Fabio I Rapisarda ◽  
Dibendu Betal ◽  
Riccardo Bonomi

ABSTRACT The introduction of breast conservation surgery together with advances in oncoplastic techniques has revolutionized the management of retroareolar breast tumours. Traditionally, cancers in this location were often managed with central excision and primary closure or mastectomy. More recently, oncoplastic breast-conserving techniques such as the Grisotti mammoplasty have been increasingly encouraged as an alternative option as it allows oncological safe margin resections while restoring cosmesis. The use of a Grisotti flap enables safe resection of a retroareolar tumour with concurrent reconstruction of the defect using a local rotational advancement dermoglandular flap allowing a satisfactory cosmetic result in term of contour and projection. This technique is often limited to those patients with sufficient native nipple-inferior mammary fold (IMF) distance to accommodate for some inevitable post-operative reduction in this distance. We describe a modification of the original description, such that satisfactory cosmetic outcome can be achieved, even in patients with a short nipple areolar complex to inframammary fold distance.


Breast Care ◽  
2017 ◽  
Vol 12 (6) ◽  
pp. 385-390 ◽  
Author(s):  
Fabian Riedel ◽  
André Hennigs ◽  
Sarah Hug ◽  
Benedikt Schaefgen ◽  
Christof Sohn ◽  
...  

Aim: To describe and discuss the evidence for oncological safety of different procedures in oncological breast surgery, i.e. breast-conserving treatment versus mastectomy. Methods: Literature review and discussion. Results: Oncological safety in breast cancer surgery has many dimensions. Breast-conserving treatment has been established as the standard surgical procedure for primary breast cancer and fits to the preferences of most breast cancer patients concerning oncological safety and aesthetic outcome. Conclusions: Breast-conserving treatment is safe. Nonetheless, the preferences of the individual patients in their consideration of breast conservation versus mastectomy should be integrated into routine treatment decisions.


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A M Alanwar ◽  
A G Osman ◽  
M A Abdelhamed ◽  
A N E Ebrahim

Abstract Background The goal of modern breast surgery is to cure patients with preservation of breast tissue as much as possible with satisfactory physical and psychological outcome. This goal has led to introduction of a new scope of surgery into our clinical practice called oncoplastic breast surgery, with the advantage of combining oncological safety and satisfactory cosmetic outcome. Objective To focus on skin sparing mastectomy as a surgical procedure for treatment of breast cancer and to assess outcomes and benefits versus complications. Patients and Methods It was a retrospective analytical study that included 30 patients aiming to clinically assess the skin sparing mastectomy as an oncoplastic technique regarding oncological safety and patient satisfaction. This study was conducted at Ain-Shams University Hospitals. Approval of the Ethical Committee and written informed consent from all participants was obtained. Results In our study 6 patients underwent SSM and 24 Patients underwent NSM owing to high tumor/breast volume ratio. In our study we were able to conduct an very good cosmetic outcome for a relatively large tumor excisions with 66.7% of the cases (20 patients) falling in excellent and very good score. In our study only one of the patients had malignant recurrence as confirmed by the pathologist in our multidisciplinary team proving that we had performed skin sparring mastectomy technique safely from oncological point of view. The follow up of the malignant recurrence was for the first year as this was the time limitation of our study. Conclusion Skin sparing mastectomy has been proven as an alternate to traditional radical mastectomy with the same oncological safety and better cosmetic outcome.


2018 ◽  
pp. 294-299
Author(s):  
Lashan Peiris ◽  
David Olson ◽  
Kelly Dabbs

Oncoplastic breast surgery combines certain plastic surgery procedures with a breast cancer resection to minimize the cosmetic penalty. We compared current practices in breast surgery in Canada and the UK, looking at the classification of oncoplastic breast surgery, management of larger tumours that would otherwise mandate a mastectomy, and the breast surgeon’s role in immediate breast reconstruction. Reconstructive breast surgery has always fallen within the domain of the plastic surgeon, but surgical subspecialization and more focused fellowship training have meant that breast surgeons with the appropriate skillset can offer these procedures. This evolution of the breast surgeon has led to the birth of a new field of breast surgery known as oncoplastic and reconstructive breast surgery. Those tasked with developing surgical training programs in Canada must now decide whether to train breast surgeons in these techniques to improve long-term quality of life among Canadian patients with breast cancer.


The Breast ◽  
2013 ◽  
Vol 22 (6) ◽  
pp. 1189-1193 ◽  
Author(s):  
Chafika Mazouni ◽  
Alix Naveau ◽  
Aminata Kane ◽  
Ariane Dunant ◽  
Jean-Rémi Garbay ◽  
...  

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Samy Ahmed Abd Elrahman ◽  
Ahmed Gamal El Din Osman ◽  
Mohammad Ahmad Abd-erRazik ◽  
Mohamed Hamdy Zaid ◽  
Ahmed Mohamed Hanafy Sayed

Abstract Background Breast cancer, according to national cancer institute, is the most common site of cancer in women in Egypt as it accounts for about 38.8% of total malignancies among Egyptian females; it is an important cause of mortality among women. Objective s: Assess the feasibility of extreme oncoplasty and achievement of negative margins in the enrolled patients. Assess the aesthetic results of the extreme oncoplasty of the enrolled patients. Patients and Methods This is a prospective cohort study to assess the feasibility of extreme oncoplasty and achievement of negative margins in the enrolled patients and the aesthetic results of the extreme oncoplasty. This study was conducted at Ain-Shams University Hospitals. Approval of the Ethical Committee and written informed consent from all participants was obtained. Extreme oncoplasty techniques was proposed for patients in whom inclusion criteria was met. Diagnosis and staging examinations were carried out according to the standard protocol being conducted at Ain Shams University Hospitals. Results We report the oncoplastic outcomes after EO in a single institutional cohort of 20 patients with multifocal/Multicenteric or large tumors (≥50mm).While no major complications were observed after EO procedure, a low rate of minor complications (7.7%) was observed. Conclusion The combination of plastic surgery techniques with breast oncology surgery gives the surgeon a new tool for treatment of breast cancer. The preliminary results of our study indicate that selective patients (with multifocal/Multicenteric or large tumors) who were initially considered for mastectomy can be alternatively treated using Extreme oncoplasty (EO) followed by radiotherapy. EO can be considered as a safe and feasible surgical option for such patients without compromising aesthetic outcomes.


2019 ◽  
Vol 52 (03) ◽  
pp. 304-308
Author(s):  
Dushyant Jaiswal ◽  
Prabha Subhash Yadav ◽  
Vinay Kant Shankhdhar ◽  
Tasneem Jaffer Belgaumwala

Abstract Introduction Breast conservation therapy (BCT) and oncoplastic breast surgery (OBS) are now established modalities of treatment for breast cancer, with proven oncological safety. Traditionally, latissimus dorsi (LD) flaps have been the one-stop solution workhorse when volume replacement is needed. We present our experience with thoracodorsal artery perforator (TDAP) and superior epigastric artery perforator (SEAP) flaps. These flaps allow the preservation of muscle structure and function. Material and Methods Data were collected prospectively of patients in whom pedicled perforator flaps after BCT were used. A handheld 8-MHz audio Doppler was used to locate the perforators. TDAP flaps were used in four patients, whereas SEAP flaps were used in two patients. Skin paddle sizes ranged from 10 × 3 cm to 21 × 7 cm. Results TDAP flaps were used in four patients, whereas SEAP flaps were used in two patients All flaps survived. No flap had partial necrosis or fat necrosis. All donor sites were closed primarily and healed uneventfully, and none had a seroma requiring aspiration. Conclusion TDAP flaps can be selectively employed when the LD muscle function needs to be preserved. SEAP flaps can also be employed as a rare option in case of lower inner quadrant defects. Pedicled perforator flaps are a useful and reliable option for volume replacement OBS in select patients for reconstructing partial mastectomy defects.


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