Oncoplastic Breast Reduction Technique and Outcomes: An Evolution over 20 Years

Losken, Albert; Hart, Alexandra M.; Broecker, Justine S.; Styblo, Toncred M.; Carlson, Grant W.

doi:10.1097/prs.0000000000003226

Cited by 72 publications

(53 citation statements)

References 38 publications

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“…This increase in OS correlates with recent breast surgeon survey results that have shown high interests in learning OS techniques amongst breast surgeons [16]. Historically, OS has evolved since its introduction in the 1980s and follows breast conservation principles that remove fairly large regions of the breast as part of the oncologic resection followed by volume displacement (mastopexy/reduction) or volume replacement (locoregional flap)techniques [4, 17, 18]. Volume replacement using a flap is a viable option in some M patients but in our study, this option has significantly decreased from 8.6 to 2.6% of reconstructions.…”

Section: Discussionmentioning

confidence: 73%

Surgical trends in breast cancer: a rise in novel operative treatment options over a 12 year analysis

Jonczyk

Jean

Graham

et al. 2018

Breast Cancer Res Treat

165

118

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Purpose Breast cancer surgical techniques are evolving. Few studies have analyzed national trends for the multitude of surgical options that include partial mastectomy (PM), mastectomy without reconstruction (M), mastectomy with reconstruction (M+R), and PM with oncoplastic reconstruction (OS). We hypothesize that the use of M is declining and likely correlates with the rise of surgery with reconstructive options (M+R, OS). Methods A retrospective cohort analysis was conducted using the ACS-NSQIP database from 2005 to 2016 and ICD codes for IBC and DCIS. Patients were then grouped together based on current procedural terminology (CPT) codes for PM, M, M+R, and OS. In each group, categories were sorted again based on additional reconstructive procedures. Data analysis was conducted via Pearson’s chi-squared test for demographics, linear regression, and a non-parametric Mann-Kendall test to assess a temporal trend. Results The patient cohort consisted of 256,398 patients from the NSQIP data base; 197,387 meet inclusion criteria diagnosed with IBC or DCIS. Annual breast surgery trends changed as follows: PM 46.3–46.1% (p = 0.21), M 35.8–26.4% (p = 0.001), M+R 15.9–23.0% (p = 0.03), and OS 1.8–4.42% (p = 0.001). Analyzing the patient cohort who underwent breast conservation, categorical analysis showed a decreased use of PM alone (96–91%) with an increased use of OS (4–9%). For the patient cohort undergoing mastectomy, M alone decreased (69–53%); M+R with muscular flap decreased (9–2%); and M+R with implant placement increased (20–40%)—all three trends p < 0.0001. Conclusion The modern era of breast surgery is identified by the increasing use of reconstruction for patients undergoing breast conservation (in the form of OS) and mastectomy (in the form of M+R). Our study provides data showing significant trends that will impact the future of both breast cancer surgery and breast training programs.

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Section: Discussionmentioning

confidence: 73%

Surgical trends in breast cancer: a rise in novel operative treatment options over a 12 year analysis

Jonczyk

Jean

Graham

et al. 2018

Breast Cancer Res Treat

165

118

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“…Current evidence is largely based on single-institution retrospective series [3][4][5][6][7][8][9][10][11][12][13][14][15] . Systematic literature reviews, meta-analyses and reviews further strengthen the evidence base but numbers in many series are small 2, [16][17][18][19][20][21][22][23][24] .…”

Section: Introductionmentioning

confidence: 99%

A population-based audit of surgical practice and outcomes of oncoplastic breast conservations in Scotland – An analysis of 589 patients

Romics

Macaskill

Fernandez

et al. 2018

European Journal of Surgical Oncology

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“…Reconstruction of defects that result from removal of between 20% to 50% of the native breast tissue may be addressed using Level 2 volume displacement procedures, especially in women with moderate to large size breasts (11). For patients with macromastia or ptosis, application of reduction-mastopexy techniques in the oncoplastic setting offers potent tools to address larger resection defects while concomitantly improving breast shape and size (23,24). The substantial parenchymal rearrangement allows for complete defect obliteration while removing skin excess and repositioning of the NAC into a more favorable location.…”

Section: Level 2 Volume Displacement Proceduresmentioning

confidence: 99%

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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Oncoplastic Breast Reduction Technique and Outcomes: An Evolution over 20 Years

Cited by 72 publications

References 38 publications

Surgical trends in breast cancer: a rise in novel operative treatment options over a 12 year analysis

Surgical trends in breast cancer: a rise in novel operative treatment options over a 12 year analysis

A population-based audit of surgical practice and outcomes of oncoplastic breast conservations in Scotland – An analysis of 589 patients

Oncoplastic partial breast reconstruction: concepts and techniques

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