Novel strategies in oncoplastic surgery for breast cancer: immediate partial reconstruction of breast defects

Abstract

Neue Strategien der onkoplastischen Chirurgie beim Mammakarzinom: Sofortteilrekonstruktion von BrustdefektenZusammenfassung. Grundlagen:Onkoplastische Chirurgie wird als Kombination aus onkologischer und plastisch-rekonstruktiver Chirurgie definiert. Die Einfü hrung der onkoplastischen Chirurgie fü r Patientinnen mit einem Mammakarzinom stellt eine der bedeutendsten Neuheiten fü r die Kosmetik und die Lebensqualitä t in der Chirurgie des Mammakarzinoms dar. Durch Vergrö ßerung der resektionsfreien Rä nder kö nnte auch eine mö gliche onkologische Verbesserung durch die onkoplastische Chirurgie zu tragen kommen. Eine tatsä chliche Reduktion des Lokalrezidivs durch onkoplastische Chirurgie konnte aber noch nicht nachgewiesen werden.Methodik: Literaturü bersicht. Ergebnisse: Diese Ü bersichtsarbeit soll die rezente Literatur zusammenfassen und die derzeit gä ngigsten onkoplastischen Methoden darstellen. Weiters zeigen wir das kosmetische Ergebnis unserer onkoplastischen Techniken mittels einer neu etablierten objektiven Analysesoftware, dem ,,breast analyzing tool'' (BAT # ).Schlussfolgerungen: Die onkoplastische Chirurgie ist die Weiterentwicklung der brusterhaltenden Therapie des Mammakarzinoms und sollte jeder Patientin, welche fü r diese Therapie in Frage kommt, angeboten werden kö nnen. Die kosmetische Analyse sollte nur mehr durch objektivierbare Analysesoftwares durchgefü hrt werden.Schlü sselwö rter: Brust-Symmetrie-Index, Brusterhaltende operation, Brustchirurgie, Onkologische Chirurgie, Brustreduktion, Brustkosmetik.Summary. Background: Oncoplastic surgery defines the use of plastic and reconstructive techniques combined with oncologic surgery. In women with breast cancer oncoplastic surgery is one of the most important novelties from the last century to improve cosmetic outcome and quality of life. Recent reports have also demonstrated a possible oncologic improvement by increasing the resection free margins. This may reduce the local-recurrence rate, however, this hypothesis remains unproven.Methods: Review of the literature.Results: This review on oncoplastic breast cancer surgery gives a short summary and update of the recent literature and demonstrates recently developed techniques. In addition we demonstrate the cosmetic outcome of patients after oncoplastic surgery using the breast analyzing tool software (BAT # ).Conclusions: Oncoplastic surgery is the next step after the introduction of breast conserving therapy for breast cancer and should be offered to any eligible patient. Cosmetic analyses should be done objectively.

Evaluation of Inferior Pedicle Therapeutic Mammoplasty as a Primary Procedure for Upper Quadrants Early Breast Cancer

“…Delayed inverted-T-incision wound healing was the most common and happened in the early cases and avoided in later cases by leaving a small triangle of skin in the midline above the inframammary fold. Fitzel et al reported that skin necrosis and wound dehiscence are the most often reported complications after therapeutic mammoplasty [13]. Partial areola necrosis encountered in one patient (3%) while wound infection occurred in another one patient (3%).…”

Therapeutic reduction mammoplasty in large-breasted women with cancer using superior and superomedial pedicles

“…18 Skin necrosis and wound dehiscence are the most often reported complications after therapeutic reduction mammoplasty. 19 Obese patients, smokers, and diabetics carry an increased risk of developing local complications. 20 In our study, there was no conversion to mastectomy due to the easy attainment of tumor-free safety margins in all cases, as a result of wider excision being possible in large breasts.…”

Recurrence and survival after standard versus oncoplastic breast-conserving surgery for breast cancer

“…Today, oncoplastic techniques are increasingly implemented in BCS, enabling surgeons to achieve better cosmesis while maintaining excellent oncological results. On average, oncoplastic BCS (OPS) has been shown to result in higher resection volumes and larger resection margins, as well as a significantly reduced re-excision rate 8–11 . A consequence of this development is that previous indications for BCS have been widened, and today BCS is generally offered to women with larger tumours than those included in the ground-breaking randomized trials by Veronesi and colleagues 12 and Fisher co-workers 1 , even though oncoplastic techniques may also be chosen for women with smaller tumours in unfavourable locations.…”