Techniques for improving the cosmetic outcome of breast conservation surgery

Shrotria, S.

doi:10.1053/ejso.2000.1050

Cited by 29 publications

(12 citation statements)

References 6 publications

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“…Various methods of breast remodeling have been described with emphasis on proper planning of incisions, minimum scarring and refashioning of breast tissue itself (mammoplasty) or using partial breast augmentation with latissimus dorsi flap for compensating for the loss of volume and better cosmetic outcome [15]. Latissimus dorsi has been described as an 'ideal mini-flap' for breast remodeling [16,17].…”

Section: Discussionmentioning

confidence: 99%

Safety of Partial Breast Reconstruction in Extended Indications for Conservative Surgery in Breast Cancer

Parmar

Hawaldar

Badwe

2010

Indian J Surg Oncol

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Breast conservation surgery after large volume excisions for women with relatively larger or multicentric operable breast cancer (OBC) and in some locally advanced breast cancers (LABC) post neo-adjuvant chemotherapy (NACT), is known to be a feasible option using a latissimus dorsi flap. However, the oncological safety of such a procedure is not well reported in literature. Two hundred and twenty one women with breast cancer (148-OBC, 73-LABC) underwent BCT plus LD during March 1998 to August 2009. One hundred and forty six women (72-LABC, 66-OBC) received prior NACT for downstaging, followed by completion of adjuvant therapy in all, including postoperative radiotherapy and hormone therapy where indicated. Women aged 20-62 years, with tumors 1.5-15 cm (median 5.0 cm), underwent volume replacement surgery with LD flap. All positive cut margins (total-4.9%, gross positive-1.3%) were re-excised to ensure negative margins. The mean surgical time for excision of primary with axillary clearance followed by volume replacement by LD was 5 h and mean hospital stay 6 days. Donor site morbidity was seen in 11 patients and 3 had minor recipient site infection. At a median follow up of 36 months, ten of 221 patients (4.5%) had failed locally (7-OBC, 3-LABC). The determinants of local recurrence were presence of lymphatic vascular invasion (p = 0.016) and axillary metastasis (p = 0.003). BCT plus LD flap is an oncologically safe, technically quick procedure with minimal morbidity, and should be offered to all eligible women as an extended breast conservation procedure.

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Section: Discussionmentioning

confidence: 99%

Safety of Partial Breast Reconstruction in Extended Indications for Conservative Surgery in Breast Cancer

Parmar

Hawaldar

Badwe

2010

Indian J Surg Oncol

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“…[5][6][7][8] Different methods of parenchymal redistribution have been described to fi ll small or moderate defects in the breast. [9][10][11][12][13] These all fundamentally rely on advancement, rotation, or transposition of a large area of the breast in order to fi ll the defect. This effectively absorbs the volume loss over a much larger area, thus decreasing the risk of a localized defect; however, wide excision removes a large amount of breast tissue and often results in poor local cosmetic results in patients with small breasts.…”

Section: Introductionmentioning

confidence: 99%

Immediate breast reconstruction using autologous free dermal fat grafts provides better cosmetic results for patients with upper inner cancerous lesions

et al. 2011

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“…2). Local tissue rearrangement employs advancement, rotation and ⁄ or transposition based on random blood supply (48,(52)(53)(54)(55)(56)(57). Wise-pattern incisions can be combined with modifications of the central-mound technique to enable resections in all regions of the breast (Fig.…”

Section: Volume Displacementmentioning

confidence: 99%

Oncological and Aesthetic Considerations of Conservational Surgery for Multifocal/Multicentric Breast Cancer

Patani¹,

Carpenter²

2010

The Breast Journal

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Conventional indications for mastectomy (MX) reflect circumstances where breast conserving therapy (BCT) could compromise oncological or cosmetic outcome. MX continues to be recommended for the majority of women with multiple lesions within the same breast. In this article, we review the oncological safety and aesthetic considerations of BCT in the context of multifocal (MF) or multicentric (MC) breast cancer. Literature review facilitated by Medline and PubMed databases. Published studies have reported divergent results regarding the oncological adequacy of BCT in the management of MF or MC disease. Earlier studies demonstrated high rates of local recurrence (LR) for BCT. More recent series have found BCT to be comparable to MX in terms of LR, distant failure, disease free and overall survival. Few studies have adequately evaluated cosmetic outcomes following BCT for MF or MC breast cancer. Contemporary oncoplastic techniques have extended the clinical utility of BCT and are of particular relevance to breast conservation in the context of MF or MC lesions. Appropriate case selection, preoperative oncological and aesthetic planning, satisfactory clearance of the surgical margins and adjuvant radiotherapy are of paramount importance. In the absence of level-1 guidance concerning the management of women with MF or MC disease, each case requires discussion with regard to tumor and patient related factors in the context of the multidisciplinary team. In selected patients with MF or MC disease, BCT is oncologically safe and cosmetically acceptable. Uniformity of practice and the establishment of a standard of care will require an evidence-base from prospective studies.

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Techniques for improving the cosmetic outcome of breast conservation surgery

Cited by 29 publications

References 6 publications

Safety of Partial Breast Reconstruction in Extended Indications for Conservative Surgery in Breast Cancer

Safety of Partial Breast Reconstruction in Extended Indications for Conservative Surgery in Breast Cancer

Immediate breast reconstruction using autologous free dermal fat grafts provides better cosmetic results for patients with upper inner cancerous lesions

Oncological and Aesthetic Considerations of Conservational Surgery for Multifocal/Multicentric Breast Cancer

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