Central round block repair of large breast resection defects: oncologic and aesthetic outcomes

Bramhall, Russell; Lee, Jason; Concepcion, Mae; Westbroek, David; Huf, Sarah; Mohammed, Kabir; Thiruchelvam, Paul; Gui, Gerald

doi:10.21037/gs.2017.06.11

Cited by 10 publications

(7 citation statements)

References 42 publications

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“…In this context, it is crucial to establish a careful selection of patients who can be potentially submitted to conservative management, based on disease location, glandular or fatty volume composition, and breast size, always doing measurements regarding symmetry and ptosis degree [ 20 ]. Furthermore, the aim to maintain a good cosmetic result is directly linked to a wide excision with radical margins and being able to prevent local recurrences or disease progression [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Subaxillary Replacement Flap Compared with the Round Block Displacement Technique in Oncoplastic Breast Conserving Surgery: Functional Outcomes of a Feasible One Stage Reconstruction

et al. 2022

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Background: For selected women diagnosed with breast cancer (BC), partial reconstructive techniques involve displacement or replacement procedures to improve cosmesis without compromising oncological safety. This study aims to evaluate the surgical outcomes of the round block (RB) compared with the subaxillary flap (SF) technique for patients with upper outer tumor. Patients and Methods: Thirty-three patients treated with oncoplastic conserving surgery (15 RB and 18 SF) were enrolled in this retrospective study. After carrying out a comparison of baseline characteristics, all cases were recruited for postoperative evaluation of oncological and cosmetic parameters. Moreover, we investigated several scoring combinations to check whether they could discriminate surgeon and patient satisfaction according to different functional results. Results: Median age (p < 0.05), average tumor size (p > 0.05), estimated resection volume (p > 0.05), and nodal involvement (p > 0.05) were slightly higher in the SF group. A greater frequency of DCIS (p < 0.05) in the RB series correlated with reintervention for positive margins (p > 0.001). At a mean follow-up of 19 months, no locoregional recurrences were recorded and early and late complications were comparable (p > 0.05). The overall satisfaction with cosmesis was characterized by similar proportions of good results (p > 0.05), with some details more related to each procedure. Conclusion: The proposed techniques represent effective solutions for reshaping that follows upper outer wide excision, achieving comparable complication rates, low reinterventions, and good aesthetic results in relation to technical and social functioning evaluations. However, it is crucial to establish a careful patient selection in order to manage correct surgical planning while predicting any potential sequelae or complication.

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Section: Discussionmentioning

confidence: 99%

Subaxillary Replacement Flap Compared with the Round Block Displacement Technique in Oncoplastic Breast Conserving Surgery: Functional Outcomes of a Feasible One Stage Reconstruction

et al. 2022

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“…While the overall percentage of seroma from pooled data was 6.5% (95% CI: 3.7%-11.4%). The highest percentage (28.6%) was reported by Bramhall et al, [17] .…”

Section: Discussionmentioning

confidence: 78%

“…The overall percentage of wound dehiscence/ delayed wound healing from pooled data is 3.3% (95% CI: 2.2%-5.1%). Only four studies reported that complication Bramhall et al [17] , Mohsen et al [10] , Refaat et al, [21] and Kyung In et al [14] the highest among them was Mohsen et al [10] with a percentage of 6.7%.…”

Section: Discussionmentioning

confidence: 97%

“…For example, Bramhall et al, [17] reported 12 patients with positive margins, 5 patients underwent re-excision successfully and other 7 patients underwent completion mastectomy for multiple involved margins. Zaha et al, [16] reported that one patient had positive margins after re-excision who refused further surgery and treated by radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

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Round Block Technique in the Management of Breast Cancer, Meta-Analysis Study

ABD-ERRAZIK¹,

ABDELNASSER

2022

The Medical Journal of Cairo University

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Background: Breast cancer is the one of the important medical issues nowadays. The surgical treatment of breast cancer has evolved greatly over the past years. It has developed from a radical procedure to a procedure combining both oncologic and aesthetic principles. Upon well-understanding of the anatomy of the breast, surgeons could develop the oncoplastic procedures. Aim of Study:To assess, through the available literature, the oncologic and aesthetic outcomes of the Round Block Technique and to identify the post-operative complications after the use of this technique.Material and Methods: Publications from Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available on the Internet till 2021. This is a meta-analysis of the Round Block Technique in the surgical management for breast cancer. It was done from December 2020 till January 2022. This review was conducted according to the Preferred Reporting Items for Meta-Analyses (PRISMA) guidelines. 80 The PRISMA Statement was published in 2009. If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures.Results: As regards the total post-operative complications, they were low after the use of the Round Block Technique. It had a percentage of 17.2% (95% CI: 12.4-23.4%). Infection was reported in percentage of 4% (95% CI: 2.9%-5.5%), seroma had a percentage of 6.5% (95% CI: 3.7%-11.4%), hematoma had a percentage of 3.8% (95% CI: 2.6%-5.4%), wound complications had a percentage of 3.3% (95% CI: 2.2%-5.1%) while the Nipple-areola complex complications had a percentage of 2.4% (95% CI: 0.8&-6.9%). After all these results, it's obvious that the Round Block technique had a low rate of different types of post-operative complications. Conclusion:Round Block technique is an excellent choice as an oncoplastic technique in patients with early breast cancer with mild to moderate ptosis. It's safe oncologically with a

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“…Oncoplastic surgery increases the indication for BCS in case of large tumors or tumors at difficult locations of the breast, making it possible to obtain better cosmetic results and adequate surgical margins 1,2,7,10 . Tumors located at the upper quadrants can be excised and repaired by different oncoplastic techniques, including glandular reshaping or undermining, inferior pedicle mammaplasty 21 , round-block 22 , racket resection 7,23 , batwing technique 24 , among others. The main issues of all these techniques are repositioning the areola at the center of the new breast and avoiding a filling defect due to insufficient tissue after reshaping.…”

Section: Discussionmentioning

confidence: 99%

Burow’s triangle advancement flap: a reliabletool on oncoplastic breast-conserving surgery

Letzkus

Río

Rencoret³

et al. 2021

Mastology

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Oncoplastic techniques in breast cancer treatment allow increasing indications of breast-conserving surgery and improving cosmetic results. Breast tumors located at the superior edge of the upper quadrant or at the upper inner quadrant represent a challenge for conservative surgery due to insufficient breast thickness and risk of skin involvement. We present a modified Burow's triangle advancement flap for breast-conserving surgery in patients with breast tumors at these locations. This retrospective observational study analyzed 8 out of 213 patients submitted to major oncoplastic breast procedures, who underwent breast-conserving surgery with matrix rotation mammaplasty, using a modified Burow's triangle advancement flap. All patients were treated in public and private health systems in Santiago, Chile. The median age at diagnosis was 47 years. The average initial tumor size was 5.9 cm, and the mean excised breast weight was 117 g. Patients required neither symmetrization nor displacement of the nipple-areola complex. Only one patient had a minor complication (wound dehiscence). During follow-up, no local recurrences were reported. We conclude that the modified Burow's triangle advancement flap is a safe and effective technique to manage tumors at this complex location. It provides adequate oncological margins, good cosmetic results, and contralateral symmetry, with complication rates similar to those of standard conservative surgery.

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Central round block repair of large breast resection defects: oncologic and aesthetic outcomes

Abstract: Central round block reconstruction of large defects after WLE is a safe technique with good aesthetic outcomes. Contralateral symmetrising surgery is not usually required.

Cited by 10 publications

References 42 publications

Subaxillary Replacement Flap Compared with the Round Block Displacement Technique in Oncoplastic Breast Conserving Surgery: Functional Outcomes of a Feasible One Stage Reconstruction

Subaxillary Replacement Flap Compared with the Round Block Displacement Technique in Oncoplastic Breast Conserving Surgery: Functional Outcomes of a Feasible One Stage Reconstruction

Round Block Technique in the Management of Breast Cancer, Meta-Analysis Study

Burow’s triangle advancement flap: a reliabletool on oncoplastic breast-conserving surgery

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