The Oncoplastic Reduction Approach to Breast Conservation Therapy: Benefits for Margin Control

Losken, Albert; Pinell-White, Ximena; Hart, Alexandra M.; Freitas, Alessandrina M.; Carlson, Grant W.; Styblo, Toncred M.

doi:10.1177/1090820x14545618

Cited by 64 publications

(43 citation statements)

References 27 publications

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“…Our mean OPD is 31 mm, a condition that has been directly related to higher rates of PMR, RR and CMR but conversely, our rates are in line with reported results for lesions smaller than 15 mm …”

Section: Discussioncontrasting

confidence: 60%

“…Our mean OPD is 31 mm, a condition that has been directly related to higher rates of PMR, RR and CMR 25-30 but conversely, our rates are in line with reported results for lesions smaller than 15 mm. 31,32 Furthermore, despite several experiences reporting higher rates of PMR, RR, and CMR for DCIS 33,34 or tumors previously treated with NACT 35,36 our study refutes these data.…”

Section: Discussioncontrasting

confidence: 54%

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Results obtained with level II oncoplastic surgery spanning 20 years of breast cancer treatment: Do we really need further demonstration of reliability?

et al. 2019

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Oncoplastic surgery (OPS) has demonstrated its superiority above traditional breast conserving surgery, but is still struggling to consolidate its role in breast cancer therapeutic protocols mainly because of contrasting scientific evidences and reduced follow‐up results available. The objective of our contribution is to analyze results obtained with 381 patients consecutively treated in our Multidisciplinary Breast Center by means of level II OPS between January 1998 and January 2018 for unilateral, primary breast cancer. Surgical endpoints were mean specimen weight and volume, mean diameter of main lesion (MLD), rates of positive margins (PMR), re‐excision (RR), conversion to mastectomy (CMR), complications (CR) and oncological endpoints as overall survival (OS), disease‐free survival (DFS), and local recurrence rate (LR). About 29.1% were treated for multifocal/multicentric disease, and 29.1% previously underwent neo‐adjuvant chemotherapy (NACT). Regarding surgical techniques, 53.0% of patients received “inverted T” and 30.1% “J” mammoplasties, whereas 13.6% underwent “round block,” 2.3% “Grisotti,” and 1% “batwing” techniques. Regarding surgical outcomes, mean specimen weight was 215 g (50‐2157) and volume 345 mm3 (21‐7980). MLD 23 mm, PMR 7.6%, RR 3.6%, CMR 1.6%, and CR 5.8%. With a mean follow‐up of 118 months, oncological outcomes were: OS 93.7%, DFS 82.3%, LR 4.4%. In conclusion, our analysis confirmed level II OPS reliability even for longer follow‐up timing and in difficult situations as multifocal disease or after NACT.

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Section: Discussioncontrasting

confidence: 60%

Section: Discussioncontrasting

confidence: 54%

Results obtained with level II oncoplastic surgery spanning 20 years of breast cancer treatment: Do we really need further demonstration of reliability?

et al. 2019

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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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“…[10][11][12] This technique allows for the removal of large amounts of breast tissue, thereby allowing for wider tumor margins while improving cosmetic results. 9,[13][14][15][16][17][18] Patients experience greater improvement in body image satisfaction and larger gains in body image perception. 18,19 They value the aesthetic benefit gained by performing simultaneous bilateral reduction mammoplasty with partial mastectomy.…”

mentioning

confidence: 92%

“…[6][7][8] Additionally, recent studies have shown that oncoplastic surgery allows for improved margin control with lower reexcision rates and lower recurrence rates. 9 Bilateral reduction mammoplasty is a valuable oncoplastic technique in women with preoperative macromastia and patients with large tumor-to-breast ratios. [10][11][12] This technique allows for the removal of large amounts of breast tissue, thereby allowing for wider tumor margins while improving cosmetic results.…”

mentioning

confidence: 99%

Comparison of Mammographic Findings Following Oncoplastic Mammoplasty and Lumpectomy Without Reconstruction

et al. 2015

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Although substantial tissue rearrangement is performed at the time of oncoplastic reduction mammoplasty, our results reveal no increased incidence of postoperative mammographic abnormalities or unnecessary biopsies compared to lumpectomy alone. This demonstrates that fear of increasing mammographic abnormalities and biopsies after reduction mammoplasty is unfounded and should not prevent utilization of this technique if it can optimize cosmetic outcomes and extend the option of breast conservation.

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The Oncoplastic Reduction Approach to Breast Conservation Therapy: Benefits for Margin Control

Abstract: 4.

Cited by 64 publications

References 27 publications

Results obtained with level II oncoplastic surgery spanning 20 years of breast cancer treatment: Do we really need further demonstration of reliability?

Results obtained with level II oncoplastic surgery spanning 20 years of breast cancer treatment: Do we really need further demonstration of reliability?

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

Comparison of Mammographic Findings Following Oncoplastic Mammoplasty and Lumpectomy Without Reconstruction

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