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Oncoplastics

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https://read.qxmd.com/read/32221203/oncoplastic-procedures-in-preparation-for-nipple-sparing-mastectomy-and-autologous-breast-reconstruction-controlling-the-breast-envelope
#1
Arash Momeni, Suhail Kanchwala, Hani Sbitany
BACKGROUND: Nipple-sparing mastectomy has been associated with superior aesthetic outcomes and oncologic safety. However, traditional contraindications, such as breast ptosis/macromastia, have excluded a large number of patients. The purpose of this study was to determine whether a staged approach would expand the indications for nipple-areolar complex preservation and permit greater control over nipple-areolar complex position and skin envelope following autologous reconstruction. METHODS: A retrospective analysis was conducted of female patients with a diagnosis of breast cancer or BRCA mutation with grade 2 or 3 ptosis and/or macromastia who underwent bilateral (oncoplastic) reduction/mastopexy (stage 1) followed by bilateral nipple-sparing mastectomy with immediate reconstruction with free abdominal flaps (stage 2)...
April 2020: Plastic and Reconstructive Surgery
https://read.qxmd.com/read/32209100/volume-replacement-with-diced-acellular-dermal-matrix-in-oncoplastic-breast-conserving-surgery-a-prospective-single-center-experience
#2
Hongki Gwak, Ye-Won Jeon, Seung-Taek Lim, Seon-Young Park, Young-Jin Suh
BACKGROUND: Several studies have reported the use of acellular dermal matrix in breast reconstruction. However, the primary role of acellular dermal matrix in these studies was to support the implant; there are no reports on the use of acellular dermal matrix exclusively as volume replacement. Thus, we aimed to evaluate the safety and effectiveness of filling of the defect with acellular dermal matrix in oncoplastic breast-conserving surgery. METHODS: We prospectively recruited 120 adult breast cancer patients who were scheduled to undergo oncoplastic breast-conserving surgery with acellular dermal matrix filling from 2017 to 2018...
March 24, 2020: World Journal of Surgical Oncology
https://read.qxmd.com/read/32203992/chest-wall-perforator-flaps-for-partial-breast-reconstruction-surgical-outcomes-from-a-multicenter-study
#3
Soni Soumian, Rishikesh Parmeshwar, Mihir Chandarana, Sekhar Marla, Sankaran Narayanan, Geeta Shetty
BACKGROUND: Perforator artery flaps based on the branches of intercostal arteries and lateral thoracic artery can be used for reconstruction after breast-conserving surgery (BCS). Although described more than a decade ago, these have not been adopted widely in clinical practice. We report on short-term and long-term surgical outcomes of partial breast reconstruction using chest wall perforator flaps from a prospective multicenter audit. METHODS: All patients operated for BCS and partial breast reconstruction using intercostal artery perforator or lateral thoracic artery perforator flaps from January 2015 to October 2018 were included in the analysis...
March 2020: Archives of Plastic Surgery
https://read.qxmd.com/read/32192908/the-traditional-versus-endoscopic-assisted-latissimus-dorsi-harvest-in-oncoplastic-surgery-a-long-term-comparison-of-breast-volume-aesthetics-and-donor-site-outcomes
#4
Hsien Pin Chang, Kenneth L Fan, Seung Yong Song, Dong Won Lee
BACKGROUND/OBJECTIVE: Volume replacement with the latissimus dorsi (LD) is an option for patients after partial mastectomy. Although potential benefits of using the endoscopic technique have been previously described, previous studies have not assessed long term volume and aesthetic outcomes compared to traditional methods. In this study, we aim to compare the endoscopic, latissimus only harvest to the traditional latissimus with skin paddle method. METHODS: Eleven patients underwent breast reconstruction with the traditional LD flap harvesting method; 9 underwent endoscopically assisted LD flap reconstruction...
March 17, 2020: Asian Journal of Surgery
https://read.qxmd.com/read/32170410/factors-influencing-the-time-to-surgery-after-neoadjuvant-chemotherapy-in-breast-cancer-patients
#5
Carolin Müller, Ingolf Juhasz-Böss, Gilda Schmidt, Peter Jungmann, Erich-Franz Solomayer, Georg-Peter Breitbach, Stephanie Juhasz-Böss
PURPOSE: It is suspected that delayed surgery after neoadjuvant chemotherapy (NACT) leads to a worse outcome in breast cancer patients. We therefore evaluated possible influencing factors of the time interval between the end of NACT and surgery. METHODS: All patients receiving NACT due to newly diagnosed breast cancer from 2015 to 2017 at the Department of Gynecology, Saarland University Medical Center, were included. The time interval between end of NACT and surgery was defined as primary endpoint...
March 14, 2020: Archives of Gynecology and Obstetrics
https://read.qxmd.com/read/32144083/intraoperative-ultrasound-and-oncoplastic-combined-approach-an-additional-tool-for-the-oncoplastic-surgeon-to-obtain-tumor-free-margins-in-breast-conservative-surgery-a-2-year-single-center-prospective-study
#6
Leonardo Barellini, Marco Marcasciano, Federico Lo Torto, Alfonso Fausto, Diego Ribuffo, Donato Casella
BACKGROUND: The main goal of oncoplastic breast-conserving surgery (OBCS) is to obtain tumor-free resection margins after cancer excision with satisfactory cosmetic results. Positive tumor margins are associated with high rates of tumor recurrence requiring reoperation. The aim of this prospective clinical trial was to demonstrate the reliability of intraoperative ultrasound (IOUS) to obtain tumor-free resection margins in OBCS. PATIENTS AND METHODS: Between December 2016 and March 2018, data from 130 patients with by T1-2 breast cancer, either invasive or in situ, who underwent OBCS were prospectively collected...
December 6, 2019: Clinical Breast Cancer
https://read.qxmd.com/read/32109157/surgical-trends-in-breast-cancer-in-turkey-an-increase-in-breast-conserving-surgery
#7
Güldeniz Karadeniz Çakmak, Selman Emiroğlu, Atakan Sezer, Nuh Zafer Canturk, Levent Yeniay, Bekir Kuru, Hasan Karanlık, Aykut Soyder, Şehsuvar Gökgöz, Gürhan Sakman, Muhammed Ucuncu, Mufide Nuran Akcay, Sadullah Girgin, Sibel Ozkan Gurdal, Mustafa Emiroglu, Serdar Ozbas, Abdullah Bahadir Öz, Cumhur Arici, Osman Toktas, Orhan Demircan, Adnan Çalık, Ayfer Kamali Polat, Gokturk Maralcan, Seher Demirer, Vahit Ozmen
PURPOSE: Breast cancer is the most frequent cancer in women, and there is a great variability in surgical practice for treating that cancer in different countries. The aims of this study were to analyze the effect of guidelines from the Turkish Federation of Breast Diseases Societies on academic institutions that have breast centers and to evaluate surgical practice in Turkey in 2018. PATIENTS AND METHODS: Between January and March 2019, a survey was sent to breast surgeons who were working in breast centers in academic institutions...
February 2020: JCO global oncology
https://read.qxmd.com/read/32105024/onkoplastisk-brystbevarende-kirurgi
#8
Christian Korvald, Inger Christine L'orange
Oncoplastic breast-conserving surgery extends the indication for breast-conserving surgery. Oncoplastic techniques are used to reshape or replace breast tissue during cancer surgery, in order to retain quality of life and a natural breast that also tolerates necessary post-surgical treatment. This treatment is considered to be oncologically safe, compared to traditional breast-conserving surgery and mastectomy.
February 25, 2020: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
https://read.qxmd.com/read/32042810/oncoplastic-technique-using-a-lateral-mammary-adipofascial-flap-for-the-breast-conserving-reconstruction
#9
Jiang Wu, Changjiao Yan, Lei Wang, Yuqing Yang, Rui Ling, Nanlin Li
Achieving satisfactory cosmetic results after breast-conserving surgery (BCS) can be difficult for breast cancer patients with large tumors. To avoid breast asymmetries and deformation, we present a case of breast reconstruction after BCS with a lateral mammary adipofascial flap, which was dissociated along the sentinel lymph node biopsy incision. During the procedure, the pedicled flap was transferred into the residual tumor cavity through a tunnel between them and then matched the residual cavity. The sufficient blood supply of the transferred flap was observed in ultrasound at follow-up...
December 2019: Annals of Translational Medicine
https://read.qxmd.com/read/32042687/evolution-of-minimal-access-breast-surgery
#10
REVIEW
Chi Wei Mok, Hung-Wen Lai
Surgical management of breast cancer has been evolving rapidly over the past 20-30 years. Prior to this, conventional surgical options were limited to either a mastectomy or breast conserving surgery. The demand for better aesthetic outcomes had driven the development of oncoplastic breast conserving surgery where glandular rearrangement or replacement coupled with thoughtfully placed incisions became the standard approach to breast conserving surgery. As breast surgeons and patients demand for improved aesthetic outcomes, minimally invasive or minimal access breast surgery has gained much attention over the past two decades, from endoscopic assisted to robotic-assisted breast surgery more recently...
December 2019: Gland Surgery
https://read.qxmd.com/read/32042667/a-novel-adaptable-radiographically-opaque-multi-plane-continuous-filament-marker-for-optimizing-tissue-identification-radiation-planning-and-radiographic-follow-up
#11
Sunny Mitchell, Henry Lee, Beth Baughman DuPree, David C Beyer, Michael Ulissey, Stephen R Grobmyer, Jennifer Gass, Susan Boolbol, Toni Storm-Dickerson
Background: In breast cancer treatment, marking the tumor bed is an important aspect of the surgical component of therapy. Clear delineation of the tumor bed allows radiation oncologists a defined target for planning and delivering postoperative radiation therapy (XRT). Tumor bed marking also allows radiographic follow-up of the tumor bed on subsequent breast imaging. The aim of this assessment is to evaluate the ease and feasibility of utilizing a tumor bed filament marker (VeraFormÒ, Videra Surgical inc...
December 2019: Gland Surgery
https://read.qxmd.com/read/32020633/oncoplastic-mammaplasty-with-geometric-compensation-evolution-of-the-technique-outcomes-and-follow-up-in-a-multicentre-retrospective-cohort
#12
Régis Resende Paulinelli, Vilmar Marques de Oliveira, Fábio Bagnoli, Jaime Letzkus Berríos, Milca Cézar Chade, Larissa Bragatto Picoli, Thauana Dias Santos, Ana Paula Bastos de Carvalho, Luiz Fernando Jubé Ribeiro, Ruffo Freitas-Junior
BACKGROUND AND OBJECTIVES: To report on the outcomes and evolution of an oncoplastic mammaplasty referred to as geometric compensation mammaplasty. METHODS: Seventy-three patients with malignant tumours were operated on and followed up in five centres in two countries. Preoperative markings were performed using a Wise pattern. The resection of affected skin was geometrically compensated using another area of preserved skin. RESULTS: Mean pathological tumour size was 30...
February 4, 2020: Journal of Surgical Oncology
https://read.qxmd.com/read/32008945/significantly-reducing-implant-loss-rates-in-immediate-implant-based-breast-reconstruction-a-protocol-and-completed-audit-of-quality-assurance
#13
H J Knight, J J Musgrove, M M G Youssef, D J Ferguson, S B Olsen, R L Tillett
INTRODUCTION: Immediate implant-based breast reconstruction (IBR) rates have increased considerably with the advent of acellular dermal matrices. Implant loss is a significant complication and is costly to patients and the NHS. National Mastectomy and Breast Reconstruction Audit and Implant-Based Breast Reconstruction Audit data have demonstrated national implant loss rate of 9% at 3 months. National Oncoplastic Guidelines for Best Practice cite a < 5% target. We aimed to reduce implant loss by introducing a protocol with pre-, intra- and post-operative interventions...
December 27, 2019: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://read.qxmd.com/read/32003721/oncological-outcomes-in-oncoplastic-breast-surgery-a-single-institution-analysis
#14
A Lombardi, S Maggi, G Stanzani, V Vitale, L Bersigotti, C Romano, J Vittori, E Pastore, C Amanti
Oncoplastic surgery is a well-acknowledged technique that combines conserving treatment in breast cancer with plastic surgery reconstruction. The aim of our analysis is to evaluate the safety of this surgical procedure in the setting of invasive primary breast cancer, and then compare breast oncoplastic surgery with the Veronesi quadrantectomy.We have analyzed 1541 patients who underwent breast surgery for primary breast tumor between October 2004 and May 2018 at Sant'Andrea University Hospital in Rome: 880 women experienced the breast oncoplastic approach, while 660 patients received conservative surgery alone...
September 2019: Il Giornale di Chirurgia
https://read.qxmd.com/read/31995336/an-alternative-to-standard-lumpectomy-a-5-year-case-series-review-of-oncoplastic-breast-surgery-outcomes-in-a-canadian-setting
#15
Sarah Knowles, Jessica Maxwell, Alycya Lumsden, Lydia Pearson, Jessica Pulhin, Jesse McLean, Muriel Brackstone, Renee Hanrahan
Background: Oncoplastic surgery (OPS) is becoming the new standard of care for breast-conserving surgery (BCS). It has become increasingly popular in Europe; however, it has not yet been widely accepted in North America. This study aims to describe the experience with OPS at a Canadian tertiary care centre. Methods: This study is a retrospective case series consisting of consecutive OPS cases at a single Canadian centre, the Royal Victoria Regional Health Centre in Barrie, Ontario, between 2009 and 2015...
January 29, 2020: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://read.qxmd.com/read/31989380/patient-reported-outcome-after-oncoplastic-breast-surgery-compared-with-conventional-breast-conserving-surgery-in-breast-cancer
#16
Michael Rose, Henry Svensson, Jürgen Handler, Ute Hoyer, Anita Ringberg, Jonas Manjer
INTRODUCTION: Oncoplastic breast surgery (OBS) has developed as an extension of breast-conserving surgery (BCS) in an effort to improve esthetic and functional outcome following surgery for breast cancer. The aim of the present study was to evaluate the possible benefits of OBS, as compared with BCS, with regard to health-related quality of life (HRQoL), using patient-reported outcome measures (PROMs). PATIENTS AND METHODS: Patients treated with OBS (n = 200) and BCS (n = 1304) in the period 1 January 2008 to 31 December 2013 were identified in a research database and in the Danish Breast Cancer Cooperative Group (DBCG) registry...
January 27, 2020: Breast Cancer Research and Treatment
https://read.qxmd.com/read/31942343/improvement-of-superomedial-breast-reduction-and-mastopexy-with-a-new-hammock-flap
#17
Angelica Aquinati, Adriana Tuttolomondo, Giovanni Ruocco, Michele Riccio
Oncoplastic breast reduction shares similar aims and principles with esthetic surgery. Superomedial breast reduction provides harmony, symmetry, and satisfactory lower pole projection, but long-term outcomes are not consistently good. We describe our experience with a new hammock-shaped flap, which was combined with superomedial pedicle breast reduction to improve long-term outcomes by enhancing pedicle support and preventing ptosis recurrence. Methods: From January 2017 to June 2018, 10 patients underwent unilateral breast reduction (n = 7) or bilateral esthetic reduction (n = 3) by a novel approach combining a superomedial pedicle and a perforator-based inferior advancement flap...
July 2019: Plastic and Reconstructive Surgery. Global Open
https://read.qxmd.com/read/31942328/a-novel-level-i-oncoplastic-surgery-technique-for-tumors-located-in-uiq-of-the-breast-far-from-the-nipple-the-cross-technique
#18
Ahmad Kaviani, Sanaz Zand, Amir Ashraf-Ganjouei, Rami Younan, Remy Jacques Salmon
Breast surgery was revolutionized with the use of oncoplastic reshaping techniques minimizing breast deformities and esthetic complications. However, the application of the current oncoplastic techniques becomes challenging in some situations such as small-size breasts and when the tumors are located in special locations of the breast, for example, upper inner quadrant. In this article, an optimized oncoplastic technique named the "Cross" technique is introduced to overcome the abovementioned problems in the surgery of breast tumors located in the upper inner quadrant far from the center of the breast...
July 2019: Plastic and Reconstructive Surgery. Global Open
https://read.qxmd.com/read/31933122/fat-necrosis-in-level-i-oncoplastic-breast-conserving-surgery-focusing-on-a-modified-round-block-technique
#19
Hisamitsu Zaha, Tokiwa Motonari, Norie Abe, Mikiko Unesoko
The modified round block technique (MRBT) is a level I oncoplastic breast-conserving surgery (OBCS), which contains a very wide glandular flap created by extensive dual-plane undermining that is achieved by entire subcutaneous dissection and approximately 50% dissection of the breast parenchyma from the pectoralis muscle. A retrospective analysis was performed for 100 patients who underwent OBCS using MRBT from February 2009 to October 2017. The incidence of positive margin was 7.0% (seven cases), and there has been no local recurrence during a median follow-up period of 68 months...
January 13, 2020: Breast Cancer: the Journal of the Japanese Breast Cancer Society
https://read.qxmd.com/read/31926592/is-oncoplastic-breast-conserving-surgery-oncologically-safe-a-meta-analysis-of-18-103-patients
#20
Sebastian Kosasih, Salim Tayeh, Kefah Mokbel, Abdul Kasem
BACKGROUND: Oncoplastic Breast Conserving Surgery (OBCS) allows adequate resection margins of tumours unsuitable for standard breast conserving surgery (SBCS) whilst allowing for better cosmesis and reduced morbidity when compared to mastectomy. However, there is limited evidence on its oncological safety. METHODS: This study aims to compare oncological safety of OBCS with SBCS and mastectomy by examining the relative risk of cancer recurrence and re-operation rates through meta-analysis...
January 2, 2020: American Journal of Surgery
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