Oncoplastics: Techniques for reconstruction of partial breast defects based on tumor location

Abstract

Breast conservation therapy (BCT) has become an increasingly popular treatment for breast cancer. Unfortunately, many women who undergo BCT will have a deformity that may require surgical correction. The field of oncoplastics has also become increasingly popular and seeks to prevent these contour deformities during BCT. This review approaches oncoplastic reconstruction by outlining different techniques based on tumor location.

Radiation Therapy for Breast Cancer Patients Who Undergo Oncoplastic Surgery

“…The oncoplastic incision was an "inverted-T" for 18 breasts, modified "L" or "J" shape incision for 4, batwing for 1, and other for 3. 5,8 Of the 22 cases that did not have prior contralateral RT for breast cancer (2 patients) or simultaneous bilateral breast cancers (1 patient), contralateral reduction mammoplasty was performed in 11 (50%) cases at the time of oncoplastic surgery and 9 to 22 months later for 4 (18%) cases. Surgical clips were placed by the surgical oncologist into the tumor bed cavity walls after resection and before oncoplastic reconstruction in 18 of the 26 cases.…”

“…1,5 Slight modifications may shorten or eliminate the horizontal component of the incision producing a single vertical extension or an "L" or "J" incision with 1 side arm in the inframammary fold. 1,8 Excluded from analysis were patients who underwent lumpectomy without oncoplastic surgery, lumpectomy and simple breast-flap advancement closure, cosmetic breast reduction surgery with incidental discovery of cancer in the pathology specimen, and lumpectomy with partial breast RT or brachytherapy.…”

“…The oncoplastic incision location may have no relationship to the tumor bed. 1,4,5,8 The presence of a seroma pocket palpable on examination or visualized on computed tomography (CT) simulation may be related to the plastic surgery reconstruction rather than the tumor bed that is typical in lumpectomy defects. To evaluate this dilemma, we have performed a review of our RT experience with breast cancer patients who have undergone oncoplastic surgery.…”

Dermoglandular rotation flap with subaxillary advancement flap as an oncoplastic technique for breast cancer

“…Skin incision was marked for partial mastectomy and dermoglandular rotation flap. The choice of oncoplastic technique was based on the location of the tumor …”

“Diamond” mammoplasty as a part of conservative management of breast cancer: Description of a new technique

“…Several level I OPS techniques have been described to manage tumorectomy defects in the superior location. 3,9 Round-block technique was adapted from the original Benelli mastopexy. 10,11 It starts with two concentric peri-areolar incisions.…”