Oncoplastic surgery for breast cancer based on tumour location and a quadrant-per-quadrant atlas

Clough, Krishna B.; Ihraï, T.; Odén, S.; Kaufman, Gabriel J.; Massey, Eleanore; Nos, Claude

doi:10.1002/bjs.8877

Cited by 152 publications

(135 citation statements)

References 20 publications

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“…Standard lumpectomy typically excises less tissue and presumes a seroma cavity which heals through scarring. Standard adjuvant radiation to the lumpectomy site increases scar formation, often leading to poor aesthetic outcomes including nipple retraction and deviation [23]. With LVOS, the lumpectomy cavity is obliterated with tissue rearrangement thus minimizing nipple retraction and skin depression and potentially improving future aesthetics [23].…”

Section: Discussionmentioning

confidence: 99%

A Cost-Utility Analysis Comparing Oncoplastic Breast Surgery to Standard Lumpectomy in Large Breasted Women

Chatterjee¹,

Offodile²,

Asban³

et al. 2018

ABCR

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Purpose: Ablative options, beyond mastectomy, for large breasted patients with breast cancer include oncoplastic resection via reduction pattern and standard lumpectomy. Oncoplastic resection also entails a contralateral procedure for symmetry and the potential benefit of a superior cosmetic outcome. Our aim was to examine the cost-effectiveness of this treatment strategy comparing it to standard lumpectomy in treating breast cancer patients. Methods: A literature review was performed of the probabilities and outcomes related to treatment of unilateral breast cancer via oncoplastic resection or unilateral lumpectomy. Utility score surveys were used to estimate the quality adjusted life years (QALYs) associated with a successful procedure, additional margins excision and post-operative complications. A decision analysis tree was developed to highlight the more cost-effective strategy. An Incremental Cost-Utility Ratio (ICUR) was calculated. Sensitivity analysis was performed to check the robustness of our data. Results: Oncoplastic resection was associated with fewer positive margins relative to standard lumpectomy (10.0% versus 18%). In cases with positive margins, a greater percentage of oncoplastic resection patients chose a mastectomy compared to the lumpectomy patients (72% versus 19%). Utility scores for a successful operation favored oncoplastic resection (92.6 versus 86.

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Section: Discussionmentioning

confidence: 99%

A Cost-Utility Analysis Comparing Oncoplastic Breast Surgery to Standard Lumpectomy in Large Breasted Women

Chatterjee¹,

Offodile²,

Asban³

et al. 2018

ABCR

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“…In addition, to achieve the desired oncological results, this change may play an important role to get good cosmetic outcomes and improve quality of life in patients (1,2). New innovations are created in the mentioned surgical techniques, emphasizing more on the cosmetic results after surgery through the reconstruction of partial mastectomy, called oncoplastic (3)(4)(5). Different studies showed desirable and appropriate therapeutic results for this method such as good cosmetic outcomes, better control over tumor margin, high satisfaction of patients, and high probability of breast conservation (6)(7)(8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Surgical Margin After Breast Cancer Surgery Between Oncoplastic Technique and Conventional Breast-Conserving Surgery

et al. 2018

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Background: Compared to other breast surgery methods, the accurate determination of pathologic margin in oncoplastic technique can affect its development and further employment of this technique. The current study aimed at evaluating positive pathologic margin after oncoplastic surgery and comparing it to that of the conventional breast-conserving surgery. Methods: The current cross sectional and prospective study enrolled patients with breast cancer referring to the surgical clinic of Tehran Cancer Institute from 2010 to 2013. In this study, patients with breast cancer were evaluated based on the type of surgery (oncoplastic or conventional breast-conserving) they had undergone. Accordingly, the positive or negative result of the margin surgery was compared between the groups. Results: In the current study, 317 patients with breast cancer underwent the surgery during the study period (154 patients in the oncoplastic and 163 patients in the conventional breast-conserving surgery groups). The highest frequency in the oncoplastic surgery belonged to Omega method (27.3%). The pathological evaluations after surgery showed ductal breast carcinoma in most of the cases in both groups (oncoplastic surgery = 94.2%; conventional breast-conserving surgery = 90.8%; P = 0.053). Positive margin in oncoplastic surgery and conventional breast-conserving surgery groups were 10.4% and 18.4%, respectively (P = 0.043). Among the 317 studied subjects, 14 relapse cases were observed; in 7 cases, mastectomy and in the rest, re-excision were conducted. Two out of 14 cases belonged to the positive margin group. Conclusions: Using oncoplastic surgery as a method for breast surgery may play an important role in reducing the prevalence of positive margins compared to the conventional breast-conserving surgery.

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“…Oncologic breast reconstructions can be classified depending on the oncological procedure performed and the timing of breast reconstruction. There is no consensus on either the classification to be used in defects that can occur in breast cancer surgery or the ideal OBS technique to be used for correction of this problem (14,15). Although many authors have made some algorithm suggestions on this subject, most breast center use algorithms based on their own experience.…”

Section: Current Status and Oncologic Breast Reconstructions;mentioning

confidence: 99%

“…The NAC is raised and repositioned in the midline without excision of too much breast and skin tissue. The same process is applied to the contralateral breast for breast symmetry (15,25).…”

Section: A-breast Volume Displacement;mentioning

confidence: 99%

“…The size of the tumor, tumor/breast volume ratio, tumor location (upper, inner quadrant), progression rate (inflammatory carcinoma), stage of the cancer, and the size of the area to be excised with the tumor should be evaluated. The choice of oncoplastic technique according to these breast and tumor related characteristics are debated (15,16). The addition of the skills and preferences of surgeons make the decision even more complex.…”

Section: A-breast Volume Displacement;mentioning

confidence: 99%

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The Role of Oncoplastic Breast Surgery in Breast Cancer Treatment

Emiroğlu¹,

Sert²,

Inal

2015

J Breasth Health

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The aim of this study is to discuss indications, advantages, disadvantages, oncologic and aesthetic results of Oncoplastic Surgery (OBS). Pubmed and Medline database were searched for articles published between 1998 and 2014 for keywords: oncoplastic breast surgery, therapeutic mammoplasty, oncoplastic breast reduction, synchrenous reconstructions. Role of OBS in breast cancer surgery, its aspects to be considered, its value and results have been interpreted. This technique has advantages by providing more extensive tumourectomy, yielding better aesthetic results compared with breast conserving surgery, allowing oncoplastic reduction in breast cancer patients with macromastia, with higher patient satisfaction and quality of life and by being inexpensive due to single session practice. As for its disadvantages are: re-excision is more difficult, risk for mastectomy is higher, it is depent on the Surgeron's experience, it has a risk for delay in adjuvant therapies and its requirement for additional imaging studies during management. Main indications are patients with small tumour / breast volume, macromastia, multifocality, procedures which can disrupt breast cosmesis such as surgeries for upper inner breas tquadrient tumours. Contraindications are positive margin problems after wide excision, diffuse malign microcalsifications, inflammatory breast cancer, history of radiotherapy and patients' preferences. Despite low evidence level, Oncoplastic Breast Surgery seems to be both reliable and acceptable in terms of oncologic and aesthetic aspects. Oncoplastic Breast Surgery increase the application rate of breast conserving surgery by obviating practical limitations and improve the results of breast conserving surgery. Correct patient and technique choice in OBS is vital for optimization of post surgical

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Oncoplastic surgery for breast cancer based on tumour location and a quadrant-per-quadrant atlas

Cited by 152 publications

References 20 publications

A Cost-Utility Analysis Comparing Oncoplastic Breast Surgery to Standard Lumpectomy in Large Breasted Women

A Cost-Utility Analysis Comparing Oncoplastic Breast Surgery to Standard Lumpectomy in Large Breasted Women

Comparison of Surgical Margin After Breast Cancer Surgery Between Oncoplastic Technique and Conventional Breast-Conserving Surgery

The Role of Oncoplastic Breast Surgery in Breast Cancer Treatment

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