Oncoplastic mammaplasty with geometric compensation: Evolution of the technique, outcomes and follow‐up in a multicentre retrospective cohort

Abstract

Background and Objectives To report on the outcomes and evolution of an oncoplastic mammaplasty referred to as geometric compensation mammaplasty. Methods Seventy‐three patients with malignant tumours were operated on and followed up in five centres in two countries. Preoperative markings were performed using a Wise pattern. The resection of affected skin was geometrically compensated using another area of preserved skin. Results Mean pathological tumour size was 30.42 ± 21.98 mm. Twenty tumours (30.77%) were locally advanced and 15 (20.55%) were multicentric. Twenty‐two patients (34.38%) were submitted to neoadjuvant chemotherapy. Cosmetic results were considered good or excellent in 59 cases (80.82%). Margins were positive in two cases (2.74%). Complications were partial wound dehiscence (n = 11; 15.07%), fat necrosis (n = 9; 12.33%), skin necrosis (n = 5; 6.85%), seromas (n = 5; 6.85%), enlarged scars (n = 7; 9.59%) and infection (n = 2; 2.74%). There were three cases of local recurrence (4.29%), two of bone metastasis (2.86%) and three of metachronous contralateral breast cancer (4.35%). No deaths were recorded within a mean follow‐up of 35.33 ± 28.21 months. Conclusions The technique allowed breast conservation in situations requiring a large resection of skin in difficult positions, with a high rate of free margins, correction of ptosis, satisfactory symmetry and few complications.

Outcome reporting in therapeutic mammaplasty: a systematic review

“…All 75 studies used subjective aesthetic assessments; six studies also used objective methods (Breast Cancer Conservative Treatment. Cosmetic results (BCCT.core) software 40 , 45 , 78 , 90 , 91 or breast symmetry index 92 ).…”

“…Numeric or qualitative scoring systems were most commonly used for subjective assessment ( n = 72, 96.0 per cent), based on patient self-assessment or clinical assessment ( Table 4 ). In 27 studies (36.0 per cent) 31 , 40 , 42 , 65 , 66 , 68 , 73 , 85 , 86 , 88 , 90 , 93–108 , subjective aesthetic outcome assessment utilized two-dimensional digital patient photographs, where specified. In four studies 74 , 95 , 109 , 110 , patients were questioned ‘informally’, or the methodology was unclear.…”

“…In four studies 74 , 95 , 109 , 110 , patients were questioned ‘informally’, or the methodology was unclear. Only 19 studies used previously validated or published assessment tools 42 , 45 , 47 , 54 , 63 , 73 , 81 , 90 , 92–94 , 97 , 98 , 111–116 . One study compared the results of their own institutional aesthetic questionnaire with the Breast Cancer Treatment Outcomes Scale and found a significant correlation 117 .…”

“…Other studies used more than one or regular assessments after surgery ( n = 9) 68 , 92–94 , 101 , 102 , 108 , 132 , 137 such as every 3–12 months after surgery, or reported a range of time points used for assessment ( n = 3) 86 , 88 , 107 . Some investigators assessed aesthetic outcome after adjuvant therapy, at 6 months ( n = 4) 42 , 45 , 70 , 138 , 12 months ( n = 1) 134 , regular intervals ( n = 2) 38 , 103 , within a reported range of measurement points ( n = 2) 90 , 106 or at an unspecified time afterwards ( n = 4) 58 , 85 , 120 , 129 . Kim and colleagues, measured aesthetic outcome at 6 months after operation or after chemoradiation 125 , if this finished later than 6 months after surgery.…”

Inverted-T pattern reduction mammoplasty in bilateral breast ptosis: cosmetic and oncological outcomes

“…Clough et al (4) summarized an Atlas and classification for OPS, among which the inverted-T technique was performed for resections ranging 20-50% of the breast volume (level II OPS). Currently the inverted-T pattern techniques matched with suitable pedicles have been adopted for oncoplastic mammoplasty and received satisfying outcomes (5,6). However, more evidences are needed to further demonstrate the reliability of this technique.…”