J Breast Cancer.  2011 Dec;14(4):253-261. 10.4048/jbc.2011.14.4.253.

Oncoplastic Surgical Techniques for Personalized Breast Conserving Surgery in Breast Cancer Patient with Small to Moderate Sized Breast

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Kyungpook National University College of Medicine, Daegu, Korea.
  • 2Department of Surgery, Kyungpook National University College of Medicine, Daegu, Korea. phy123@knu.ac.kr

Abstract

Oncoplastic surgery has revolutionized the field of breast conserving surgery (BCS). The final aims of this technique are to obtain an adequate resection margin that will reduce the rate of local recurrence while simultaneously improving cosmetic outcomes. To obtain successful results after oncoplastic surgery, it is imperative that patients be risk-stratified based on risk factors associated with positive margins, that relevant imaging studies be reviewed, and that the confirmation of negative margins be confirmed during the initial operation. Patients who had small- to moderate-sized breasts are the most likely to be dissatisfied with the cosmetic outcome of surgery, even if the defect is small; therefore, oncoplastic surgery in this population is warranted. Reconstruction of the remaining breast tissue is divided into volume displacement and volume replacement techniques. The use of the various oncoplastic surgeries is based on tumor location and excised breast volume. If the excised volume is less than 100 g, the tumor location is used to determine which technique should be used, with the most commonly used technique being volume displacement. However, if the excised volume is greater than 100 g, the volume replacement method is generally used, and in cases where more than 150 g is excised, the latissimus dorsi myocutaneous flap may be used to obtain a pleasing cosmetic result. The local recurrence rate after oncoplastic surgery was lower than that of conventional BCS, as oncoplastic surgery reduced the rate of positive resection margins by resecting a wider section of glandular tissue. If the surgeon understands the advantages and disadvantages of oncoplastic surgery, and the multidisciplinary breast team is able to successfully collaborate, then the success rate of BCS with partial breast reconstruction can be increased while also yielding a cosmetically appealing outcome.

Keyword

Defect; Oncoplastic surgery; Personalized medicine; Personalized; Repairing

MeSH Terms

Breast
Breast Neoplasms
Cosmetics
Displacement (Psychology)
Female
Humans
Precision Medicine
Mammaplasty
Mastectomy, Segmental
Recurrence
Risk Factors
Cosmetics

Figure

  • Figure 1 This figure shows an algorithm of oncoplastic surgical techniques for personalized BCS in small- to moderate-sized breasts based on the excised breast tissue volume and tumor location. ICAP=intercostal artery perforator; TDAP=thoracodorsal artery perforator; LD=latissimus dorsi; BCS=breast conserving surgery.


Cited by  2 articles

Surgical Techniques for Personalized Oncoplastic Surgery in Breast Cancer Patients with Small- to Moderate-Sized Breasts (Part 1): Volume Displacement
Jung Dug Yang, Jeong Woo Lee, Young Kyoo Cho, Wan Wook Kim, Seung Ook Hwang, Jin Hyang Jung, Ho Yong Park
J Breast Cancer. 2012;15(1):1-6.    doi: 10.4048/jbc.2012.15.1.1.

Surgical Techniques for Personalized Oncoplastic Surgery in Breast Cancer Patients with Small- to Moderate-Sized Breasts (Part 2): Volume Replacement
Jung Dug Yang, Jeong Woo Lee, Young Kyoo Cho, Wan Wook Kim, Seung Ook Hwang, Jin Hyang Jung, Ho Yong Park
J Breast Cancer. 2012;15(1):7-14.    doi: 10.4048/jbc.2012.15.1.7.


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