Oncoplastic surgery of the breast (OPS) has generated great excitement over the past years and has become an integrated component of the surgical treatment of breast cancer. Oncoplastic surgical procedures associate the best surgical oncologic principles to achieve wide tumor-free margins with the best principles of plastic surgery to optimize cosmetic outcomes. Thanks to oncoplastic techniques, the role of breast conserving surgery (BCS) has been extended to include a group of patients who would otherwise require mastectomy to achieve adeguate tumor clearance. As OPS continues to gain acceptance and diffusion, an optimal and systematic approach to these techniques is becoming increasingly necessary. This article has the aim to review the essential principles and techniques associated with oncoplastic surgery, based on the data acquired through an extensive search of the PUBMED and MEDLINE database for articles published using the key words "breast cancer oncoplastic surgery". This review analyzes possible the advantages", classifications, indications, and the criteria for a proper selection of oncoplastic techniques to facilitate one's ability to master these procedures and make OPS a safe and an effective procedure.
"The volume-displacement procedures were then sub-classified by Clough et al.   into two levels: (I) Including excision of less than 20% of breast volume, without neither skin excision nor mammoplasty; (II) Including anticipated resection of 20–50% breast volume, with excision of excess skin required to reshape the breast based on mammoplasty techniques. However, volume-replacement procedures are still possible to use, in small or medium size breasts, even if only 20–50% of the breast volume is anticipated to be resected . Nevertheless, patients with centrally located breast tumors (CLBT), who account for 5–20% of breast cancer cases, have been routinely denied, and for a long time, the opportunity for breast conservation , strikingly, the NSABBP (B06) undertaken by Fisher and his colleagues  and including 1843 patients did not report one single case of central tumor as candidate for conservative therapy. "
[Show abstract][Hide abstract] ABSTRACT: Oncoplastic breast surgery is a standard treatment of early breast cancer, offering a balance between good cosmetic outcome and limited risk of locoregional recurrence, by enabling proper resection margins.Aim of studyTo present multiple techniques of partial breast reconstruction following the resection of centrally located breast cancer (CLBC) resection.Patients and methodsFrom January 2011 to August 2014, 21 patients underwent central quadrantectomy for carcinoma of the central region of the breast. Excisions included the nipple/areola complex, in most of the cases, down to the pectoralis fascia with a wide safety margin, and proper axillary management. Oncoplastic approaches included latissimus dorsi flap, inferior pedicle flap, Melon slice, Grisotti and round block techniques.ResultsMean age of patients was 49.5 ± 10.61 years. Tumor size ranged from 1.5 to 4.5 cm. Postoperative pathology revealed a tumor mean safety margin of 2.5 ± 0.83 cm, with positive axillary lymph nodes in 15 (75.0%) patients. Nineteen (95.0%) patients received postoperative breast radiotherapy, while 9/20 (45.0%) and 3/20 (15.0%) received adjuvant chemotherapy or hormonal therapy, respectively, and only 8/20 (40.0%) patients received both therapies. During a median follow-up period of 14.89 months, neither local nor distant metastasis, were detected. The postoperative cosmetic result evaluated by the patients was excellent in 6/20 patients (30.0%), good in 11/20 patients (55.0%), fair in 3/20 (15.0%) with neither poor nor bad results, with an overall mean of 4.0 ± 0.5 equivalent to 80% satisfaction.Conclusion
Multiple oncoplastic breast surgery techniques can be used for the resection of CLBC with satisfying cosmetic outcomes.
Journal of the Egyptian National Cancer Institute 11/2014; 26(4). DOI:10.1016/j.jnci.2014.10.003
[Show abstract][Hide abstract] ABSTRACT: Oncoplastic surgery of the breast has generated great excitement over the past years and has become an integrated component of the surgical treatment of breast cancer. Oncoplastic procedures (OPP) associate the best surgical oncologic principles to achieve wide tumor-free margins with the best principles of plastic surgery to optimize cosmetic outcomes. Thanks to oncoplastic techniques, the role of breast conserving surgery (BCS) has been extended to include a group of patients who would otherwise require mastectomy to achieve adeguate tumor clearance. However, even with the use of OPP, cosmetic outcomes may result unsatisfying when a large volume of parenchyma has to be removed, particularly in small-medium size breasts. Recently, it has been proposed the use of ORC (Oxidized Regenerated Cellulose) as a reconstructive biomaterial to optimize the aesthetic results after OPP. The aim of this article is to describe the standard pattern of an innovative surgical oncoplastic technique with ORC, that we have called "QUORC" (QUadrantectomy with Oxidized Regenerated Cellulose), to improve cosmetic results and minimize the possible postoperative complications. Key words: Breast cancer, Cosmetic results, Oncoplastic surgery results, Oxidized regenerated cellulose, QUORC.
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