Modern Trends in the Breast Cancer Conserving Surgery and Oncoplastic Breast Surgery

2018 ◽  
Vol 63 (6) ◽  
pp. 51-58
Author(s):  
А. Зикиряходжаев ◽  
A. Zikiryahodjaev ◽  
М. Ермощенкова ◽  
M. Ermoshchenkova ◽  
А. Каприн ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Social Life ◽  
Breast Surgery ◽  
Malignant Tumors ◽  
Radical Resection ◽  
Oncoplastic Surgery ◽  
Disease Stage ◽  
Oncoplastic Breast Surgery ◽  
One Stage ◽  
Oncology Research

Introduction: The highest priority for modern clinical oncology is functionally-sparing and organ-conserving treatment. In Russia, breast cancer (BC), among all malignant tumors, accounted for 21.1 % of women in 2017. Oncoplastic radical resections (OPS-BCS = oncoplastic surgery – breast conserving surgery) have been widely used. This term means resection of the breast for cancer using plastic surgery to restore the shape of the breast, in most cases with one-stage correction of the contralateral breast. Purpose: It was the creation of various techniques of oncoplastic breast surgery, applicable for the appropriate localization of breast cancer and the evaluation of surgical, oncological and aesthetic results. Methods: From 2013 to 2017, in the P.A. Hertsen Moscow Oncology Research Center, organ-conserving surgery were performed in 570 patients with BC with an average age of 54.2. Stage 0 was diagnosed in 4.6 %, I – 5.9 %, IIA – 28.7 %, IIB – 6 %, IIIA – 5.1 %, IIIC – 3.3 %, IIIB – 0.2 %, IV – 0.2 %. Radical resection in the standard version was performed in 290 patients with breast cancer, oncoplastic breast surgery in various modifications – in 280. All patients after the organ-conserving surgical treatment received radiation therapy. Patients received chemotherapy, targeted therapy and hormone therapy according to the indications in depending the disease stage and the immunohistochemical type of the tumor. Results: After an urgent and planned morphological study positive margins of resection were revealed in 10 patients, which required reresection of the edges to a negative state of them in case of an urgent intraoperative response and mastectomy – in case of a planned response. Within 4 years, local recurrences were detected in 4 patients (0.7 %), which required a mastectomy with a one-stage reconstruction. In 1 patient (0.2 %), the disease progressed as metastases to the lung – in this case lobectomy and a necessary chemotherapy were conducted. Cosmetic results were defined as excellent in 70 % cases, good – 25 %, satisfactory – 5 %. Conclusion: If there are indications for organ-conserving treatment of breast cancer and the patient’s decision concerning this surgery, the patient should be offered methods of oncoplastic surgery for the prevention of psychological and emotional stress, effective rehabilitation, and a quick return to active social life.

scholarly journals SURGICAL TREATMENT OF BREAST CANCER: FROM THE CONCEPT OF ERADICATION TO AESTHETIC SURGERY

2018 ◽  
Vol 14 (2) ◽  
pp. 42-53 ◽  
Author(s):  
I. K. Vorotnikov ◽  
V. P. Letyagin ◽  
I. V. Vysotskaya ◽  
V. Yu. Sel’chuk ◽  
D. A. Burov ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Surgical Treatment ◽  
Surgical Technique ◽  
Historical Development ◽  
Breast Surgery ◽  
Aesthetic Surgery ◽  
Oncoplastic Surgery ◽  
Oncoplastic Breast Surgery

This article discusses the historical development of oncoplastic surgery, describes the main stages of oncoplastic breast surgery, indications and contraindications for it, and the algorithms for choosing an appropriate surgical technique for patients with breast cancer.

scholarly journals Skin Sparing Mastectomy as an Oncoplastic Surgery Technique for Breast Cancer treatment

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A M Alanwar ◽  
A G Osman ◽  
M A Abdelhamed ◽  
A N E Ebrahim
Keyword(s):  
Breast Cancer ◽  
Breast Surgery ◽  
Volume Ratio ◽  
Radical Mastectomy ◽  
Cosmetic Outcome ◽  
University Hospitals ◽  
Psychological Outcome ◽  
Oncoplastic Breast Surgery ◽  
Large Tumor ◽  
Oncological Safety

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.

scholarly journals Oncoplastic and reconstructive breast surgery in Canada: breaking new ground in general surgical training

2018 ◽  
pp. 294-299
Author(s):  
Lashan Peiris ◽  
David Olson ◽  
Kelly Dabbs
Keyword(s):  
Breast Cancer ◽  
Surgical Training ◽  
Breast Surgery ◽  
Fellowship Training ◽  
Immediate Breast Reconstruction ◽  
Oncoplastic Breast Surgery ◽  
The Uk

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.

scholarly journals Oncoplastic Approaches to Breast Conservation

2011 ◽  
Vol 2011 ◽  
pp. 1-16 ◽  
Author(s):  
Dennis R. Holmes ◽  
Wesley Schooler ◽  
Robina Smith
Keyword(s):  
Breast Cancer ◽  
Multidisciplinary Approach ◽  
Breast Surgery ◽  
Breast Conservation ◽  
Surgical Techniques ◽  
Tumor Location ◽  
Surgical Approaches ◽  
Oncoplastic Breast Surgery ◽  
Body Habitus ◽  
Skill Sets

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.

scholarly journals Oncoplastic breast surgery technique for retroareolar breast cancer: a technical modification of the Grisotti flap in patients with short nipple to inferior mammary crease distance

2020 ◽  
Vol 2020 (9) ◽  
Author(s):  
Miguel Johnson ◽  
Lorna Cook ◽  
Fabio I Rapisarda ◽  
Dibendu Betal ◽  
Riccardo Bonomi
Keyword(s):  
Breast Cancer ◽  
Primary Closure ◽  
Breast Surgery ◽  
Breast Conservation ◽  
Original Description ◽  
Breast Conservation Surgery ◽  
Oncoplastic Breast Surgery ◽  
Nipple Areolar Complex ◽  
Areolar Complex ◽  
Conservation Surgery

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.

scholarly journals The role of Oncoplastic Breast Surgery in the management of breast cancer treated with primary chemotherapy

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

Extreme Oncoplastic Breast Surgery in Patients Presented to Ain Shams University Hospital, Initial Experience

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
Keyword(s):  
Breast Cancer ◽  
Breast Surgery ◽  
University Hospital ◽  
Inclusion Criteria ◽  
University Hospitals ◽  
Oncoplastic Breast Surgery ◽  
Aesthetic Results ◽  
The Aesthetic ◽  
Written Informed Consent ◽  
Staging Examinations

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.

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