Excellent aesthetic results were more frequent in the OP group according to BCCT.core software analysis and specialists. In addition, some clinical conditions and tumor locations in the breast can be considered risky factors for poor aesthetic outcomes in lumpectomy.

Oncoplastic surgery (OP) represents a major advance in breast cancer surgery. It is based on three principles: ideal oncology surgery with free margins and adequate local control of disease, immediate breast reconstruction and symmetry, with the transposition of plastic surgery techniques into breast cancer surgery. Its original focus was to improve the quality of life of patients undergoing oncological treatments that can be more effective from the aesthetic-functional point of view than the traditional breast conserving techniques. As it happens with all changes of paradigms, it brings new challenges for the traversal formation of all involved in the treatment of breast cancer. Besides that, it opens to new perspectives of surgical research related to the aesthetic results, quality of life and local control, as well as optimization of operative timing and reduction of both adverse effects and costs. The aim of this review was to present the principles of this approach and the main techniques applied, evaluating its indications and limits in conservative breast cancer surgery.

RESUMO -O trabalho analisou a celulose liofilizada como invólucro de lesões de nervos periféricos, com perda de substância, investigando a intensidade de reação inflamatória e o alinhamento axonal. Dez cães foram divididos em 3 grupos: Grupo 1 -seccção e recolocação de 1 cm de nervo ciático; Grupo 2 -não recolocado fragmento seccionado; Grupo 3 -sutura epineural, sem invólucro celulósico. A recuperação motora iniciou na oitava semana, lenta e progressiva, sem recuperação total. A autópsia mostrou reação fibrótica ao redor da celulose e aderência ao plano muscular. Quando o enxerto foi recolocado, constatou-se continuidade do nervo com aumento de calibre local. Nos dez cães foi observada fibrose e regeneração neural variáveis na área de secção do nervo. Os grupos 1 e 3 mostraram coaptação entre cotos e enxerto. Concluiu-se que a celulose liofilizada provocou moderada reação fibrótica com realinhamento e crescimento axonal quando foi recolocado, como enxerto, o fragmento do nervo seccionado.PALAVRAS-CHAVE: nervo periférico, trauma, celulose. Use of lyophilized cellulose in peripheral nerve lesions with loss of substanceABSTRACT -Lyophilized cellulose was analysed to verify the degree of inflamatory reaction and axon realignement in the sciatic nerve after loss of neural substance. Ten mongrel dogs were divided into: Group 1 -1 cm section of sciatic nerve which was replaced at lesion site; Group 2 nerve section without fragment replacement. The section site was involved with lyophilized cellulose. Group 3 -1 cm fragment section sutured epineurally. Motor response started at eighth week. Moderate fibrotic reaction to cellulose was seen in Group 1 and 2 animals. Groups 1 and 3 showed coaptation between the nerve and nerve graft with ongoing axons. In Group 2, 1 dog showed regrouth of axons through the empty space. It was concluded that lyophilized cellulose caused moderate fibrous reaction when implanted in peripheral nerve lesions with loss of substance; it can act as envellop protection in those lesions mainly if a neural graft is inserted.

Background and Objectives Marking positive lymph nodes (LNs) before neoadjuvant chemotherapy (NAC) may improve the accuracy of sentinel lymph node biopsy (SLNB). The aim of this study was to determine the feasibility of marking LNs with 4% carbon microparticle suspension (CMS) before NAC and to evaluate if this technique would improve the SLNB identification rate. Methods A prospective study of patients with cT1‐T4, cN1‐N2 breast cancer who underwent US‐guided fine‐needle aspiration biopsy (FNAB) of suspected LNs and concomitant marking with 4% CMS was performed. After NAC, LNs marked with 4% CMS and those marked with Patent Blue V dye (PBV) were identified and resected. Results Of the 123 patients included, 74 (60.1%) had positive LNs at FNAB. During axillary surgery, 4% CMS was identified in 121 of 123 patients (98.3%) and blue sentinel LNs in 91% (112 of 123 patients) (P = .0103). Comparing isolated results of PBV and 4%CMS + PBV, the association was better in identifying positive LNs (72.2% vs 97.7%) (P = .02). Conclusion The association of 4% CMS and PBV is feasible and significantly increased the identification rate of positive LNs. 4% CMS may play an important role as a complementary technique in patients submitted to NAC.