Surgical, oncologic, and cosmetic differences between oncoplastic and nononcoplastic breast conserving surgery in breast cancer patients

Tenofsky, Patty L.; Dowell, Phaedra; Topalovski, Terri; Helmer, Stephen D.

doi:10.1016/j.amjsurg.2013.09.017

Cited by 104 publications

(71 citation statements)

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“…It has been suggested that the rate of fat necrosis is higher after OBCS than after reduction mammoplasty or lumpectomy [5,6]. However, the authors did not report whether the fat necrosis was detected by clinical, radiological or pathological diagnosis in their series.…”

Section: Discussioncontrasting

confidence: 43%

“…Fat necrosis, as complication of OBCS, has been reported to be found in 6.3-26% of patients [3,5,6,7,19,20]. It has been suggested that the rate of fat necrosis is higher after OBCS than after reduction mammoplasty or lumpectomy [5,6].…”

Section: Discussionmentioning

confidence: 99%

“…Extensive parenchymal manipulation, older age, high body mass index (BMI), large tumour size and medical risk factors that are irreversible over a short term increase the complication rate to 27% in OBCS patients [3,5,6,7,8,9]. …”

Section: Introductionmentioning

confidence: 99%

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Imaging Results Following Oncoplastic and Standard Breast Conserving Surgery

et al. 2015

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Background: Oncoplastic breast-conserving surgery (OBCS) requires more complex surgical techniques than standard wide local excision (WLE) and the postoperative complication rate may be higher. Since these can have an impact on postoperative imaging, we compared imaging and biopsy results after OBCS and WLE. Methods: Findings for patients undergoing OBCS (n = 83) or standard WLE (n = 128) were compared. Numbers, indications and outcomes of mammograms, breast ultrasounds, magnetic resonance imaging scans and biopsies done within 2 years after surgery were analysed. Results: OBCS was applied for more advanced malignancy. Significantly more patients required breast ultrasound after OBCS than WLE (20/71 vs. 17/116; p = 0.024). Breast Imaging Reporting and Data System (BI-RADS) category 3 or 4 ultrasound results were found only in patients with OBCS (6/29 vs. 0/19; p = 0.034). Significantly more biopsies were required after OBCS (9/71 vs. 3/116; p = 0.006). New lumps or lumpiness were the commonest indications, and pathology confirmed fat necrosis in the majority (7/12). The rate of fat necrosis after OBCS was 18% on clinical examination (13/71), 15% with ultrasound (11/71) and 7% confirmed on pathology (5/71). Conclusion: Patients treated with OBCS require significantly more ultrasound scans and consequent biopsies than patients who underwent WLE. This is mainly due to fat necrosis developing after OBCS in the majority of cases.

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Section: Discussioncontrasting

confidence: 43%

Section: Discussionmentioning

confidence: 99%

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Imaging Results Following Oncoplastic and Standard Breast Conserving Surgery

et al. 2015

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“…With interest we read the article by Tenofski et al 1 This article compares the immediate and long-term complications and consequences of oncoplastic and nononcoplastic breast-conserving surgeries (BCS). It is a retrospective study of 142 procedures in 140 patients, of which 84 were traditional and 58 oncoplastic BCS.…”

mentioning

confidence: 98%

Oncoplastic surgery: fashion or necessity?

Moris

Kontos

2015

The American Journal of Surgery

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“…Careless surgical technique and complications can add to this negative situation. Additional biopsy may be required in the diagnosis of lesions such as postoperative fat necrosis and fibrosis (78).…”

Section: Oncologic and Esthetic Evaluationmentioning

confidence: 99%

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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Surgical, oncologic, and cosmetic differences between oncoplastic and nononcoplastic breast conserving surgery in breast cancer patients

Cited by 104 publications

References 10 publications

Imaging Results Following Oncoplastic and Standard Breast Conserving Surgery

Imaging Results Following Oncoplastic and Standard Breast Conserving Surgery

Oncoplastic surgery: fashion or necessity?

The Role of Oncoplastic Breast Surgery in Breast Cancer Treatment

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