Background: Breast conserving treatment (BCT) has become the standard treatment in early breast cancer; its goal is to provide a treatment as effective as mastectomy with the added benefit of a preserved breast. However, it is sometimes difficult to achieve good cosmetic results, particularly in patients with breast cancer located in the upper inner quadrant, for which the traditional conservative surgery results in a deformed breast. Aim of the work: To compare prospectively the oncoplastic results of inferior pedicle mammaplasty and doughnut mastopexy as techniques for early breast cancers located at the upper inner quadrant. Patients and Methods: This is a prospective randomized study on twenty female patients who were diagnosed to have early breast cancer located in the upper inner quadrant and are candidates for oncoplastic breast surgery. The study was conducted at Ain Shams University Hospitals. Approval of the Ethical Committee and written informed consent from all participants were obtained. Patient selection was achieved through a number of inclusion and exclusion criteria. Results: There is significant difference between the two groups as regards the operative time, intraoperative blood loss, hospital stay, total drainage volume, drainage days, postoperative complications, cosmetic outcome and the need for contralateral symmetrization. Inferior pedicle mammaplasty needs longer operative time and postoperative hospital stay and drainagy days with more intraoperative blood loss in comparison to Doughnut mastopexy. As regards the postoperative complications, we found that there are more complications in Inferior pedicle mammaplasty than Doughnut mastopexy as wound wound infection and dehiscence. Conclusion: Patients with early breast cancer located in the upper inner quadrant are candidate for either Inferior pedicle mammaplasty or Doughnut mastopexy. Doughnut mastopexy is better for them as there is less morbidity, better cosmesis, no need for contralateral symmetrization and fewer complications, so no delay in radiotherapy and Inferior pedicle mammaplasty needs more surgeon experience.
Background: Breast cancer is by far the most common cancer among women of both developed and developing countries and the leading cause of cancer death in females. The incidence of multifocal breast cancer has increased due to the improvement in imaging studies and the use of MRI. Multifocal breast cancer was previously considered a contraindication for breast conservative surgery. However, with the recent progress in the neoadjuvant systemic therapy Together with development of oncoplastic surgeries breast conservation is being increasingly performed for multifocal cases. Skin sparing mastectomy can also be used for multifocal cases with superior aesthetic results without compromising the oncological safety. Aim of the work: This study aims to compare conservative breast surgery and skin sparing mastectomy in multifocal breast cancer regarding local recurrence.Patients and methods: This is a prospective randomized clinical trial study conducted in Ain-Shams University Hospitals Breast surgery unit over 30 patients with minimal follow-up of 18 months.2 groups of patients; Group A: composed of 15 patients that undergoing conservative breast surgery for multifocal breast cancer. Group B: composed of 15 patients that undergoing skin sparing mastectomy for multifocal breast cancer. An informed consent will be taken from all patients who will accept to participate. Results:The percentage of local recurrence were found to be comparable in both groups. Also the aesthetic results and patients' satisfaction were similar in both groups. However, postoperative wound complications were higher in the skin sapring mastectomy group. Conclusion:This study suggests that any of the two procedures can safely be done to cases with multifocal breast cancer however the cosmetic results in skin sparing mastectomy group was more superior than in the conservative breast surgery group.
Background: In the modern treatment of breast cancer, the Sentinel Lymph node biopsy indication is present in many clinical circumstances, instead of classical axillary lymphadenectomy. It presents the advantage of conservative surgery, which significantly decreases the rate of postoperative complications, offering the patients a better quality of Life and reducing the costs of patients care after surgery. Sentinel Lymph node biopsy (SLNB) vs. axillary Lymph node dissection (ALND) in the current surgical treatment of early stage breast cancer. Aim of the Work: The aim of the present study is to evaluate staging the axilla with sentinel lymph node biopsy after neoadjuvant chemotherapy in previous clinically node positive axilla in breast cancer to avoid the morbidity of an ALND. Patients and Methods: This was a prospective cohort study was held in El Demerdash hospital Ain Shams University hospitals, Cairo, Egypt started with one hundred and twenty female patients with clinically node positive axilla in breast cancer. Approval of the Ethical Committee and written informed consent from all participants were obtained. Patient selection was achieved through a number of inclusion and exclusion criteria. Results: Our study showed that SLNB is acceptable in cN1/2 patients who become cN0 after neoadjuvant therapy: particularly in those with no residual disease in the breast, because SN status maintains its expected prognostic role, but also in cases with residual disease, because Axillary dissection (AD) has no influence on outcomes. Conclusion: Sentinel lymph node biopsy will replace axillary lymph node dissection (ALND) in those patients with clinically node positive axilla without compromising their oncologic outcomes. Especially, rates of pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) have increased. In the neoadjuvant setting, SLN after NAC is feasible and accurate in clinically node positive patients as a continuous effort to avoid the morbidity of ALND.
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