Kosin Med J.  2024 Sep;39(3):153-159. 10.7180/kmj.24.129.

Oncoplastic breast-conserving surgery: evolution, techniques, and the emerging role of acellular dermal matrix

• Choi JH
• Kim Y

• KMID: 2559402
• DOI: http://doi.org/10.7180/kmj.24.129

Abstract

Oncoplastic breast-conserving surgery (OBCS) has revolutionized breast cancer treatment, aiming to achieve optimal oncological outcomes while preserving an aesthetically favorable appearance. This review explores the evolution, techniques, and outcomes of OBCS, with a particular focus on the emerging role of acellular dermal matrix in volume replacement techniques. We conducted a comprehensive literature review using PubMed, Medline, and Cochrane databases, focusing on studies published between 2010 and 2024. OBCS demonstrates comparable oncological safety to traditional breast-conserving surgery, with local recurrence rates ranging from 2.7% to 5.7% at 5 years. Patient satisfaction rates are consistently high, with 85% to 95% reporting good to excellent aesthetic outcomes. Volume replacement techniques using acellular dermal matrix show promising results, with one study reporting that 94% of patients were highly satisfied with cosmetic outcomes. Although the current results are encouraging, future advancements in OBCS may require innovative approaches, including the integration of robotic surgery and artificial intelligence technologies.

Keyword

Acellular dermis; Mastectomy; Breast neoplasms; Esthetics; Reconstructive surgery procedures

Figure

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  Fig. 1. Common volume displacement techniques in oncoplastic breast-conserving surgery. (A) When the tumor was located above the nipple, a glandular advancement flap was elevated from the pectoralis muscle (dotted blue line). (B) In order to eliminate the tethering deformity, cutaneous glandular dissection was performed (dotted red line). (C) When the tumor was located in the lower outer quadrant, a mainly upper glandular advancement flap was elevated from the pectoralis muscle (dotted blue line). (D) The upper glandular advancement flap was anchored to pectoralis major muscle to prevent inframammary fold retraction. Cutaneous glandular dissection was performed (dotted red line). Reprinted from In et al. [6].

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  Fig. 2. BCCT.core software analysis of aesthetic outcomes in oncoplastic breast-conserving surgery. Reprinted from Cardoso et al. [14], with permission from Elsevier.

Reference

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