Comparison of Mammographic Findings Following Oncoplastic Mammoplasty and Lumpectomy Without Reconstruction

Introduction The potential advantages of oncoplastic breast conserving surgery (BCS) have not been validated in robust studies that constitute high levels of evidence, despite oncoplastic techniques being widely adopted around the globe. There is hence the need to define the precise role of oncoplastic BCS in the treatment of early breast cancer, with consensual recommendations for clinical practice. Methods A panel of world-renowned breast specialists was convened to evaluate evidence, express personal viewpoints and establish recommendations for the use of oncoplastic BCS as primary treatment of unifocal early stage breast cancers using the GRADE approach. Results According to the results of the systematic review of literature, the panelists were asked to comment on the recommendation for use of oncoplastic BCS for treatment of operable breast cancer that is suitable for breast conserving surgery, with the GRADE approach. Based on the voting outcome, the following recommendation emerged as a consensus statement: Oncoplastic breast conserving surgery should be recommended versus standard breast conserving surgery for the treatment of operable breast cancer in adult women who are suitable candidates for breast conserving surgery (with very low certainty of evidence). Discussion This review has revealed a low level of evidence for most of the important outcomes in oncoplastic surgery with lack of any randomized data and absence of standard tools for evaluation of clinical outcomes and especially patients’ values. Despite areas of controversy, about one-third (36%) of panel members expressed a strong recommendation in support of oncoplastic BCS. Presumably, this reflects a synthesis of views on the relative complexity of these techniques, associated complications, impact on quality of life and costs.

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“…Overall survival data was available in 7 observational studies but these were observational and prone to confounding [24,27,33,36,39,43,44].…”

Section: Overall Survivalmentioning

confidence: 99%

Should oncoplastic breast conserving surgery be used for the treatment of early stage breast cancer? Using the GRADE approach for development of clinical recommendations

Rocco¹,

Catanuto

Cinquini

et al. 2021

The Breast

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“…By the 2-and 5-year timepoints, however, the difference in rate of abnormal findings had subsided. Benign calcifications were more common in the reduction group at 1, 2, and 5 years (54).…”

Section: Surveillancementioning

confidence: 87%

Oncoplastic partial breast reconstruction: concepts and techniques

Chu¹,

Hanson²,

Hwang³

et al. 2021

Gland Surg

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Rationale & goals of oncoplastic breast reconstructionOf the approximately 250,000 new cases of breast cancer diagnosed in the United States each year, the majority present with localized disease that is confined to the primary site (1). Over the past decades, numerous observational and randomized controlled trials have demonstrated the equivalent survival conferred by breast-conserving surgery (BCS) with adjuvant radiation compared with mastectomy for patients with early-stage breast cancer (2-7). With the added benefits of less invasive and shorter surgeries, faster recovery, less frequent complications, preservation of sensation, and psychosocial advantages, breast conservation therapy (BCT) has thus evolved to become a nationallyaccepted standard of care treatment for this patient population (8).

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“…On the other hand, the ultrasonographic findings of fat necrosis are variable (ranging from a simple or complex cyst to a complex solid nodule). Although solid lesions typically have wellcircumscribed margins, they occasionally have indistinct or spiculated margins mimicking carcinoma [18,[25][26][27][28]. Cystic lesions appear as complex cysts with a mural nodule, complex cysts with echogenic bands, or round anechoic lipid cysts [29,30].…”

Section: Discussionmentioning

confidence: 99%

Natural course of fat necrosis after breast reconstruction: a 10-year follow-up study

et al. 2021

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Background Although fat necrosis is a minor postoperative complication after breast reconstruction, occasionally it mimics to tumor recurrence in patients with breast cancer. Therefore, the surgeon should distinguish between benign fat necrosis and true local recurrence. The authors evaluated the clinical characteristics of fat necrosis after breast reconstruction and investigated the natural course of fat necrosis. Methods Between 2007 and 2013, a total of 362 patients underwent breast reconstruction after partial or total mastectomy for breast cancer in Kyungpook National University Hospital. Clinicopathologic characteristics and the occurrence of fat necrosis were assessed during surveillance for 10 years of mean follow-up period. Results There were 42 cases (11.6%) of fat necrosis after breast reconstruction with partial or total mastectomy which were confirmed by needle or excision biopsy. The fat necrosis was resolved after a mean period of 45.9 months (SD, ± 42.1) and 26 cases (61.9%) of fat necrosis were almost completely resolved (less than 5 mm) during 10-year follow-up period. Conclusion Based on the natural course of fat necrosis, the fat necrosis after breast reconstruction can be only monitored, if pathologic confirmation was done. More than half of the cases will be resolved within 2–3 years.

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Comparison of Mammographic Findings Following Oncoplastic Mammoplasty and Lumpectomy Without Reconstruction

Cited by 32 publications

References 39 publications

Should oncoplastic breast conserving surgery be used for the treatment of early stage breast cancer? Using the GRADE approach for development of clinical recommendations

Should oncoplastic breast conserving surgery be used for the treatment of early stage breast cancer? Using the GRADE approach for development of clinical recommendations

Oncoplastic partial breast reconstruction: concepts and techniques

Natural course of fat necrosis after breast reconstruction: a 10-year follow-up study

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