Impact of Reduction Mammoplasty on Cosmetic Outcomes and Delivery of Hypofractionated Radiotherapy for Breast Cancer Patients Undergoing Reduction Mammoplasty as a Component of Breast-Conserving Surgery

Background. Neoadjuvant chemotherapy (NACT) is a standard of care for locally advanced breast cancer patients. One of the main advantages of NACT is the reduction of the tumor size and regression of lymph node metastasis.The aim of the study was to analyze the outcomes of breast-conserving surgery after NACT compared to adjuvant chemotherapy, including the examination of the width of resection margins and the frequency of re-operations, the volume of tissue removed and cosmetic outcomes.Material and Methods. We analyzed 1219 publications available from pubMed, Medline, Cochrane Library, 1057 of them did not meet the inclusion criteria, 162 publications were selected to cover all the following inclusion criteria: surgical margin status, frequency of re-operations, volume of tissue removed and cosmetic outcomes. Finally, 22 studies met fully specified criteria.Results. Studies included in this review demonstrated a different frequency of positive resection margins (2–39.8 %), reoperations (0–45.4 %), the volume of tissue removed (43.2–268 cm3), and the weight of the resected breast tissue (26.4–233 grams) after NACT. Conclusion. The data obtained showed a decrease in the frequency of positive resection margins and re-operations in patients who received NACT compared to patients who did not receive NACT (5–39.8 % versus 13.1–46 % and 0–45.4 % versus 0–76.5 %, respectively), as well as a decrease in the amount of the removed breast tissue without the negative effect on the frequency of resection margins, thus allowing minimization of the extent of surgery and improvement of cosmetic outcomes.

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Late radiation side effects, cosmetic outcomes and pain in breast cancer patients after breast-conserving surgery and three-dimensional conformal radiotherapy

Strahlentherapie und Onkologie ◽

10.1007/s00066-015-0899-y ◽

2015 ◽

Vol 192 (1) ◽

pp. 8-16 ◽

Cited By ~ 20

Author(s):

Ursula Hille-Betz ◽

Bernhard Vaske ◽

Michael Bremer ◽

Philipp Soergel ◽

Sudip Kundu ◽

...

Keyword(s):

Breast Cancer ◽

Side Effects ◽

Cancer Patients ◽

Three Dimensional ◽

Conformal Radiotherapy ◽

Breast Conserving Surgery ◽

Breast Cancer Patients ◽

Cosmetic Outcomes ◽

Three Dimensional Conformal Radiotherapy ◽

Radiation Side Effects

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Hypofractionated radiotherapy for breast cancer patients treated by breast-conserving surgery: short-term morbidity and preliminary results

Breast Cancer ◽

10.1007/s12282-009-0102-3 ◽

2009 ◽

Vol 17 (1) ◽

pp. 42-47 ◽

Cited By ~ 11

Author(s):

Georgios A. Plataniotis ◽

Maria-Aikaterini Theofanopoulou ◽

Konstantinia Sotiriadou ◽

Georgios Kyrgias

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Breast Conserving Surgery ◽

Hypofractionated Radiotherapy ◽

Breast Cancer Patients ◽

Short Term ◽

Preliminary Results

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Hypofractionated Radiotherapy as Adjuvant Treatment in Early Breast Cancer. A Review and Meta-Analysis of Randomized Controlled Trials

Breast Care ◽

10.1159/000439007 ◽

2015 ◽

Vol 10 (4) ◽

pp. 240-245 ◽

Cited By ~ 13

Author(s):

Wilfried Budach ◽

Edwin Bölke ◽

Christiane Matuschek

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Adjuvant Radiotherapy ◽

Meta Analysis ◽

Breast Conserving Surgery ◽

Hypofractionated Radiotherapy ◽

Breast Cancer Patients ◽

Fractionated Radiotherapy ◽

Randomized Controlled ◽

Conventionally Fractionated

Background: Adjuvant radiotherapy after breast-conserving surgery is indicated in the vast majority of breast cancer patients. Conventionally fractionated radiotherapy with 50 Gy in 25 fractions was considered standard of care for several decades. The recently publishes long-term results of randomized trials that have tested different moderately hypofractionated radiotherapy schedules that may change clinical practice. Patients and Methods: A Pubmed search was carried out to identify the relevant publications on hypofractionated radiotherapy in breast cancer. In total, 4 randomized controlled trials representing the results of 7,095 patients with 10 years of follow-up were identified. A meta-analysis on the primary end point ipsilateral breast cancer recurrence and a review of the toxicity data were performed. Results: Moderately hypofractionated radiotherapy using schedules such as 40 Gy in 15 fractions administered within 3 weeks are as efficient and safe as conventionally fractionated radiotherapy for most breast cancer patients who need adjuvant radiotherapy after breast-conserving surgery. In patients aged < 40 years, after neoadjuvant chemotherapy, and if regional lymph node radiotherapy is indicated, further data are needed. Conclusion: Moderately hypofractionated radiotherapy can be recommended as standard treatment after breast-conserving surgery in the majority of breast cancer patients.

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Changes in physical functioning of breast cancer patients following breast-conserving surgery, mastectomy with immediate breast reconstruction and mastectomy alone within the first 18 months after surgery

10.1055/s-0040-1717834 ◽

2020 ◽

Author(s):

S Albers ◽

D Speiser ◽

LWR Pachal ◽

LA Pohany ◽

M Afshar-Bakshloo ◽

...

Keyword(s):

Breast Cancer ◽

Breast Reconstruction ◽

Cancer Patients ◽

Physical Functioning ◽

Breast Conserving Surgery ◽

Immediate Breast Reconstruction ◽

Breast Cancer Patients

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Usefulness of 3D-surgical guides in breast conserving surgery after neoadjuvant treatment

Scientific Reports ◽

10.1038/s41598-021-83114-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Han Shin Lee ◽

Hee Jeong Kim ◽

Il Yong Chung ◽

Jisun Kim ◽

Sae Byul Lee ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Neoadjuvant Treatment ◽

Breast Conserving Surgery ◽

Resection Margins ◽

Breast Cancer Patients ◽

Original Tumor ◽

Surgical Guides ◽

Neoadjuvant Systemic Therapy ◽

Tumor Area

AbstractWe used 3D printed-breast surgical guides (3DP-BSG) to designate the original tumor area from the pre-treatment magnetic resonance imaging (MRI) during breast-conserving surgery (BCS) in breast cancer patients who received neoadjuvant systemic therapy (NST). Targeting the original tumor area in such patients using conventional localization techniques is difficult. For precise BCS, a method that marks the tumor area found on MRI directly to the breast is needed. In this prospective study, patients were enrolled for BCS after receiving NST. Partial resection was performed using a prone/supine MRI-based 3DP-BSG. Frozen biopsies were analyzed to confirm clear tumor margins. The tumor characteristics, pathologic results, resection margins, and the distance between the tumor and margin were analyzed. Thirty-nine patients were enrolled with 3DP-BSG for BCS. The median nearest distance between the tumor and the resection margin was 3.9 cm (range 1.2–7.8 cm). Frozen sections showed positive margins in 4/39 (10.3%) patients. Three had invasive cancers, and one had carcinoma in situ; all underwent additional resection. Final pathology revealed clear margins. After 3-year surveillance, 3/39 patients had recurrent breast cancer. With 3DP-BSG for BCS in breast cancer patients receiving NST, the original tumor area can be identified and marked directly on the breast, which is useful for surgery. Trial Registration: Clinical Research Information Service (CRIS) Identifier Number: KCT0002272. First registration number and date: No. 1 (27/04/2016).

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