Oncoplastic mammaplasty with geometric compensation-A technique for breast conservation

Paulinelli, Régis Resende; Oliveira, Vilmar Marques de; Bagnoli, Fábio; Chade, Milca Cezar; Alves, Katyane Larissa; Freitas‐Junior, Ruffo

doi:10.1002/jso.23751

Cited by 21 publications

(51 citation statements)

References 25 publications

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“…Increasingly indicated, it provides significant advantages, since it minimizes the psychological damage of a possible mutilating treatment 3,6,8,9 . Thus, it is possible to perform a greater number of breast conserving surgeries in patients who would usually undergo total mastectomy, with a lower rate of postoperative complications and a higher rate of local disease control 1,3,4,5,10 . In the classic breast conserving surgery, resections of more than 20% of the breast tissue affected by the disease generates both breast deconfiguration and contralateral asymmetry.…”

Section: Discussionmentioning

confidence: 99%

“…These techniques are called volume displacement techniques, and are used in immediate repair in the conservative treatment of the breast 4,11 . They generally present a lower risk of complications than volume replacement techniques after total mastectomy 1,11 . Surgical margins free of neoplasia correspond to a reduction in the risk of local recurrence, independently of margin size 4,8 .…”

Section: Discussionmentioning

confidence: 99%

“…However, depending on the volume of tumor and the volume of resection required for adequate cancer control, a negative aesthetic result may be obtained 1 . The criteria for breast conservation have expanded in recent years and have included larger tumors, traditionally treated by mastectomy.…”

Section: Introductionmentioning

confidence: 99%

“…Thus, it is possible to perform more extensive resections in conserving surgery without significantly compromise the final aesthetic results 2,3 . The techniques of oncoplastic breast surgery offer some advantages over the classic conservative treatment: oncologic safety with resection of voluminous tumors, higher index of free surgical margins, lower rates of reoperation and better aesthetic result 1,2 . The techniques used in oncoplastic surgery can be involving volume displacement or volume replacement 4 .…”

Section: Introductionmentioning

confidence: 99%

“…The techniques used in oncoplastic surgery can be involving volume displacement or volume replacement 4 . The volume displacement techniques are used for immediate repair in breast-conserving treatment and generally have a lower risk of complications than the techniques used for volume replacement after radical mastectomy 1 . The objective of this study is to show the results of oncoplastic techniques used in the conservative treatment of breast cancer, considering oncologic safety, free surgical margins rates and reoperation rates as well as postoperative mammary symmetry and final aesthetic results.…”

Section: Introductionmentioning

confidence: 99%

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Locoregional flaps in oncoplastic surgery and breast reconstruction

Figueiredo¹,

Pires²,

Mendonça³

et al. 2017

Rev. Bras. Mastol. (Impr.)

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Introduction: Conserving surgery in the treatment of breast cancer, in association with radiotherapy, has replaced mastectomy in most cases. However, depending on the location and size of tumor, the classic conservative surgery can present unfavourable aesthetic results and high levels of commitment of the surgical margins. The oncoplastic breast surgery can have high local control rates and cause minimum breast deformities, leading to a better aesthetic result. Objective: To report cases of 30 patients with primary unilateral breast carcinoma who underwent oncoplastic surgery between 2013 and 2015. Methods: We used local and regional dermo-glandular rotation techniques. The average age of patients was 58.9 years. The average tumor size was 2.53 cm. Three patients had close or positive surgical margins and underwent a new surgical procedure. Results: The aesthetic result was evaluated by the BCCT.core program and was considered excellent in 11 cases, good in 12 cases and regular in 7 cases. Six patients had postoperative complications. Conclusion: The use of local and regional dermo-glandular rotation techniques allows extensive resections in breast conserving surgery, leading to a satisfying symmetry and a good aesthetic result without the need of symmetrization, with low postoperative complication rates and high rates of free surgical margins.KEYWORDS: Breast cancer; breast reconstruction; surgical flaps; surgical margins; cosmetic techniques. ABSTRACT RESUMOIntrodução: A cirurgia conservadora no tratamento do câncer de mama, associada à radioterapia, tem substituído a mastectomia na maioria dos casos. Entretanto, dependendo da localização e do tamanho do tumor, a cirurgia conservadora clássica pode resultar em um resultado estético insatisfatório e em altos índices de comprometimento de margens cirúrgicas. A cirurgia oncoplástica da mama pode apresentar altas taxas de controle local, causando deformidades mamárias mínimas, levando a um melhor resultado estético. Objetivo: Relatar casos de 30 pacientes com carcinoma mamário unilateral que foram submetidas à cirurgia oncoplástica da mama entre 2013 e 2015. Métodos: Foram utilizadas técnicas de rotação dermoglandular local e regional. A idade média das pacientes foi de 58,9 anos. O tamanho médio do tumor foi 2,53 cm. Três pacientes apresentaram margens cirúrgicas exíguas ou comprometidas, sendo submetidas a novo procedimento cirúrgico. Resultados: O resultado estético foi avaliado pelo programa BCCT.core, sendo considerado excelente em 11 casos, bom em 12 casos e regular em 7 casos. Seis pacientes apresentaram complicações pós-operatórias. Conclusão: A utilização de técnicas de rotação dermoglandular local e regional permite ressecções extensas na cirurgia conservadora da mama, permitindo uma simetria satisfatória e um bom resultado estético sem a necessidade de simetrização, com baixos índices de complicação pós-operatória e altas taxas de margens cirúrgicas livres.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Locoregional flaps in oncoplastic surgery and breast reconstruction

Figueiredo¹,

Pires²,

Mendonça³

et al. 2017

Rev. Bras. Mastol. (Impr.)

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

Paulinelli

Oliveira²,

Bagnoli³

et al. 2020

Journal of Surgical Oncology

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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.

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Alternative Oncoplastic Techniques for Challenging Breast Conservative Surgeries

Paulinelli

2019

Oncoplastic and Reconstructive Breast Surgery

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Oncoplastic mammaplasty with geometric compensation-A technique for breast conservation

Abstract: The technique allowed breast conservation in situations requiring large resection of affected skin, with free surgical margins, correction of ptosis, satisfactory symmetry, and few complications.

Cited by 21 publications

References 25 publications

Locoregional flaps in oncoplastic surgery and breast reconstruction

Locoregional flaps in oncoplastic surgery and breast reconstruction

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

Alternative Oncoplastic Techniques for Challenging Breast Conservative Surgeries

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