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Breast oncoplastic surgery guidelines

Liang Q Liu, Olivier A Branford, Sinead Mehigan
Background: Since BREAST-Q was developed in 2009, it has been widely used by clinicians and researchers to capture information regarding health-related quality of life (HRQoL) and patient satisfaction related to breast surgery. Yet clinical guidelines regarding the use of BREAST-Q for assessment of success of surgery in women with breast cancer remain limited. To maximize the benefits of using BREAST-Q to inform clinical decision making, this systematic review aimed to identify and appraise current evidence on patient-reported outcomes (PROs) assessed by BREAST-Q associated with breast oncoplastic surgery...
August 2018: Plastic and Reconstructive Surgery. Global Open
J R Benson, S K Down
No abstract text is available yet for this article.
September 2017: British Journal of Surgery
Mohsen M El Gammal, Maria Lim, Rajan Uppal, Richard Sainsbury
INTRODUCTION: The National Institute for Health and Clinical Excellence guidelines recommend that breast reconstruction should be available to all women undergoing mastectomy and discussed at the initial surgical consultation (2002, and updated 2009). The National Mastectomy and Breast Reconstruction Audit (2009) showed that 21% of mastectomy patients underwent immediate breast reconstruction (IBR) and 11% had delayed breast reconstruction (DBR). Breast reconstruction has been shown to have a positive effect on quality of life postmastectomy...
2017: Breast Cancer: Targets and Therapy
György Lázár, Attila Bursics, Zoltán Farsang, László Harsányi, Csaba Kósa, Róbert Maráz, Zoltán Mátrai, Attila Paszt, Gábor Pavlovics, Róbert Tamás
Therapy for breast cancer today is characterised by ever more precise diagnostic methods and ever more effective oncological treatments, a trend which will certainly continue in the future. Breast preservation and the application of oncoplastic principles are increasingly popular. A sentinel lymph node biopsy in the surgical treatment of the axilla is primary, with the indication for axillary block dissection (ABD) narrowing and radiation therapy becoming an alternative to ABD in certain cases. This publication summarises our recommendations on the surgical treatment of breast cancer based on the content of the 2nd Breast Cancer Consensus Conference and considering the latest international studies and professional recommendations...
September 2016: Magyar Onkologia
Jessica F Rose, Jessica Suarez Colen, Warren A Ellsworth
Breast conservation therapy has emerged as an important option for select cancer patients as survival rates are similar to those after mastectomy. Large tumor size and the effect of radiation create cosmetic deformities in the shape of the breast after lumpectomy alone. Volume loss, nipple displacement, and asymmetry of the contralateral breast are just a few concerns. Reconstruction of lumpectomy defects with local tissue rearrangement in concert with reduction and mastopexy techniques have allowed for outstanding aesthetic results...
May 2015: Seminars in Plastic Surgery
Jeffrey Landercasper, Deanna Attai, Dunya Atisha, Peter Beitsch, Linda Bosserman, Judy Boughey, Jodi Carter, Stephen Edge, Sheldon Feldman, Joshua Froman, Caprice Greenberg, Cary Kaufman, Monica Morrow, Barbara Pockaj, Melvin Silverstein, Lawrence Solin, Alicia Staley, Frank Vicini, Lee Wilke, Wei Yang, Hiram Cody
BACKGROUND: Multiple recent reports have documented significant variability of reoperation rates after initial lumpectomy for breast cancer. To address this issue, a multidisciplinary consensus conference was convened during the American Society of Breast Surgeons 2015 annual meeting. METHODS: The conference mission statement was to "reduce the national reoperation rate in patients undergoing breast conserving surgery for cancer, without increasing mastectomy rates or adversely affecting cosmetic outcome, thereby improving value of care...
October 2015: Annals of Surgical Oncology
Vratislav Strnad, Jean-Michel Hannoun-Levi, Jose-Luis Guinot, Kristina Lössl, Daniela Kauer-Dorner, Alexandra Resch, György Kovács, Tibor Major, Erik Van Limbergen
OBJECTIVE: The aim was to develop a delineation guideline for target definition for APBI or boost by consensus of the Breast Working Group of GEC-ESTRO. PROPOSED RECOMMENDATIONS: Appropriate delineation of CTV (PTV) with low inter- and intra-observer variability in clinical practice is complex and needs various steps as: (1) Detailed knowledge of primary surgical procedure, of all details of pathology, as well as of preoperative imaging. (2) Definition of tumour localization before breast conserving surgery inside the breast and translation of this information in the postoperative CT imaging data set...
June 2015: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Lena Carstensen, Janne Bigaard
BACKGROUND: Breast conserving surgery (BCS) for central breast tumours with immediate reconstruction of the nipple-areola complex (NAC) is a relatively new addition to the surgical palette of the oncoplastic surgeon. Most oncoplastic techniques presented to date have only been suitable for women with large breasts. METHODS: From 2012 to 2013, a series of eligible women with central breast cancers were treated with BCS and NAC reconstruction. According to breast size and shape, three different procedures were performed...
February 2015: Breast: Official Journal of the European Society of Mastology
Michael Yunaev, Guy Hingston
INTRODUCTION: Oncoplastic breast surgery (OBS) is a developing subspecialty, although many countries are struggling with how to incorporate training in OBS as part of the established breast surgery subspecialization pathways. UK and Brazil have surged ahead with established formal training programmes, whereas countries such as Australia still rely on ad hoc training by interested surgeons. Our aim was to review the possibility of including regional training centres with appropriate OBS expertise into a future formal training programme in OBS...
September 2013: ANZ Journal of Surgery
Michael Rose, Henry Svensson
The technique and results of a tunnelled lateral fasciocutaneous flap with a skin island is described in immediate partial breast reconstruction in a subpopulation in oncoplastic breast surgery. Fifteen patients were operated on from January 2008 to January 2011. The subpopulation consisted of patients with small or medium-sized breasts. All patients had invasive ductal carcinomas, located in the lateral or central parts of the breast, of which the lumpectomy in three cases included the nipple areola complex...
December 2012: Journal of Plastic Surgery and Hand Surgery
Christoph Andree, Jian Farhadi, Dennis Goossens, Jaume Masia, Isabelle Sarfati, Günter Germann, R Douglas Macmillan, Michael Scheflan, Hans-Pieter Van Not, Giuseppe Catanuto, Maurizio Bruno Nava
OBJECTIVES: To propose initiatives and actions that could improve access to and outcomes from oncoplastic breast surgery. METHODS: The author group met in May 2010 to draft position statements on key unmet needs in oncoplastic breast surgery and how these may be addressed. At a second meeting in December 2010, the statements were voted upon and adjusted as necessary to achieve unanimous agreement. RESULTS: It was agreed that every patient undergoing breast cancer surgery should be assessed by an oncoplastic team capable of offering the full range of surgical options...
2012: Eplasty
Zoltán Mátrai, Gusztáv Gulyás, László Tóth, Csaba Polgár, Mária Bidlek, Eva Szabó, István Láng, Zsolt Horváth, Nóra Udvarhelyi, Csaba Kunos, Akos Sávolt, Pál Pesthy, Miklós Kásler
Breast screening programs along with advances in diagnostic methods and oncologic treatment have resulted in full recovery for a decisive number of patients diagnosed with early-stage breast cancer. The results of the ultra-radical-, followed by the breast conserving era pose new opportunities and challenges for the oncologic breast surgeon. The focus of oncoplastic surgery is not only on the tumor, but also on the female patient, allowing for individualized immediate breast reconstruction with acceptable esthetic result following radical tumor exstirpation...
March 2011: Magyar Onkologia
Tuomo J Meretoja, Catarina Svarvar, Tiina A Jahkola
BACKGROUND: Oncoplastic breast surgery refers to a wide range of techniques with a parallel goal of safely removing all malignant breast tissue while achieving the best possible esthetic outcome. We report the results of our oncoplastic breast operations from 2005 to 2007. METHODS: Ninety selected breast cancer patients were treated with a variety of oncoplastic operations. The patients were prospectively monitored. Radiotherapy and systemic adjuvant treatment were given according to national guidelines...
August 2010: American Journal of Surgery
Maria João Cardoso, R Douglas Macmillan, Belén Merck, Alexandre Mendonça Munhoz, Richard Rainsbury
Oncoplastic Breast Surgery (OPBS) is becoming an integral part of breast cancer management, but few surgeons have received formal training in these techniques. An International Symposium has recently debated the key issues which impact on training and specialisation in OPBS, as well as patient access to these procedures. The Symposium concluded that increasing the availability of OPBS is a major challenge, which demands much closer collaboration and cooperation between breast and plastic surgeons, backed up by new training schemes, new curricula and new guidelines...
December 2010: Breast: Official Journal of the European Society of Mastology
Krishna B Clough, Gabriel J Kaufman, Claude Nos, Ines Buccimazza, Isabelle M Sarfati
BACKGROUND: Oncoplastic surgery (OPS) has emerged as a new approach for extending breast conserving surgery (BCS) possibilities, reducing both mastectomy and re-excision rates, while avoiding breast deformities. OPS is based upon the integration of plastic surgery techniques for immediate reshaping after wide excision for breast cancer. A simple guide for choosing the appropriate OPS procedure is not available. OBJECTIVE: To develop an Atlas and guideline for oncoplastic surgery (OPS) to help in patient selection and choice of optimal surgical procedure for breast cancer patients undergoing BCS...
May 2010: Annals of Surgical Oncology
Jürgen Hoffmann, Diethelm Wallwiener
BACKGROUND: One of the basic prerequisites for generating evidence-based data is the availability of classification systems. Attempts to date to classify breast cancer operations have focussed on specific problems, e.g. the avoidance of secondary corrective surgery for surgical defects, rather than taking a generic approach. METHODS: Starting from an existing, simpler empirical scheme based on the complexity of breast surgical procedures, which was used in-house primarily in operative report-writing, a novel classification of ablative and breast-conserving procedures initially needed to be developed and elaborated systematically...
2009: BMC Cancer
N Birido, J G Geraghty
Quality assurance is the process by which quality care can be assessed. The general principles include setting a standard with the aim of achieving particular outcomes, followed by the evaluation of parameters that allow for quality assessment. Locoregional and survival outcomes are the major parameters but require years to evaluate and have other limitations. Other parameters therefore may assist in evaluation, such as the availability of the structures and processes required to achieve desired outcomes. Unlike chemotherapy and radiotherapy the quality of surgery is difficult to quantify, yet it is central to the issue of locoregional control and survival...
August 2005: European Journal of Surgical Oncology
Richard M Rainsbury
Breast surgeons are learning to adapt to an evidence-based, guideline-directed and outcome-orientated culture as key members of the multidisciplinary team. Recent data has confirmed the central role of surgery in preventing recurrence, improving survival and reducing risk, and rising scrutiny is raising the standards of breast cancer treatment. Specialization is increasing in breast surgery as a result of foreshortened training, greater patient demand and increasing trainee expectations and breast surgeons are learning new skills...
July 2003: ANZ Journal of Surgery
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