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
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
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
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
Ashvini Menon, Haitham Khalil, Babu Naidu, Ehab Bishay, Richard Steyn, Maninder S Kalkat
BACKGROUND: Despite therapeutic advances in the management of breast cancer, a significant number of patients present with locoregional recurrence. Treatment with hormonal, chemo or radiotherapy remains standard in such cases. However, in selected patients of recurrent breast cancer involving chest wall, multidisciplinary surgical approach could be considered. METHODS: Between 2010 and 2018, 21 patients with recurrent breast cancer, involving chest wall, were treated at a tertiary care center with resection and reconstruction...
January 6, 2020: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
Gianluca Franceschini, Riccardo Masetti
No abstract text is available yet for this article.
January 7, 2020: Annals of Plastic Surgery
Dushyant Jaiswal, Prabha Subhash Yadav, Vinay Kant Shankhdhar, Tasneem Jaffer Belgaumwala
Introduction  Breast conservation therapy (BCT) and oncoplastic breast surgery (OBS) are now established modalities of treatment for breast cancer, with proven oncological safety. Traditionally, latissimus dorsi (LD) flaps have been the one-stop solution workhorse when volume replacement is needed. We present our experience with thoracodorsal artery perforator (TDAP) and superior epigastric artery perforator (SEAP) flaps. These flaps allow the preservation of muscle structure and function. Material and Methods  Data were collected prospectively of patients in whom pedicled perforator flaps after BCT were used...
September 2019: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
Matthew D Riina, Ramy Rashad, Stephanie Cohen, Zachary Brownlee, Shirin Sioshansi, Jaroslaw Hepel, Abhishek Chatterjee, Kathryn E Huber
PURPOSE: The role of surgical clips as markers of the tumor bed cavity for radiotherapy boost targeting after oncoplastic surgery is not well understood. Therefore, we sought to evaluate whether the placement of surgical clips can reduce inter-observer variability in the delineation of the tumor bed cavities of oncoplastic surgery patients and ultimately, determine an optimal number of clips to place. METHODS: We reviewed records of 39 women with breast cancer who underwent oncoplastic breast surgery and adjuvant radiotherapy at our institution...
December 19, 2019: Practical Radiation Oncology
Gianluca Franceschini, Riccardo Masetti
No abstract text is available yet for this article.
December 2019: Indian Journal of Surgical Oncology
Kathy Flitcroft, Meagan Brennan, Andrew Spillane
BACKGROUND: The emergence of breast oncoplastic surgery provides women with more surgical options for improved aesthetics following breast-conserving surgery and for breast reconstruction (BR) following mastectomy. For some established breast and plastic surgeons, this development may be perceived as increasing competition for patients and raises the potential for demarcation issues between and within surgical sub-specialties. The objectives of the study were to document surgeons' views on demarcation between general/breast, oncoplastic/breast and plastic reconstructive breast surgeons in Australia, to examine the potential impact demarcation issues may have on informed patient choice and to recommend ways of reducing them...
December 17, 2019: ANZ Journal of Surgery
Lun Li, Benlong Yang, Hongyuan Li, Jian Yin, Feng Jin, Siyuan Han, Ning Liao, Jingping Shi, Rui Ling, Zan Li, Lizhi Ouyang, Xiang Wang, Peifen Fu, Zhong Ouyang, Binlin Ma, Xinhong Wu, Haibo Wang, Jian Liu, Zhimin Shao, Jiong Wu
INTRODUCTION: Available patient-reported outcome (PRO) studies are mainly from single institution or of small sample size, and the variations across hospitals and regions were not fully analysed. A multicentre, prospective, patient-reported outcome-reconstruction and oncoplastic cohort (PRO-ROC) will be planned to assess the PROs of Chinese patients with breast cancer who will undergo breast reconstruction (BR) or oncoplastic breast-conserving surgery (OBCS). METHODS AND ANALYSIS: The inclusion criteria are female patients with breast cancer aged >18 years old who will undergo BR or OBCS...
December 15, 2019: BMJ Open
Hiroshi Fujimoto, Nobumitsu Shiina, Takeshi Nagashima, Takafumi Sangai, Junta Sakakibara, Mamoru Takada, Ryotaro Teranaka, Haduki Takishima, Yohei Kawasaki, Masayuki Ohtsuka
BACKGROUND AND OBJECTIVES: We investigated the effects of oncoplastic breast-conserving surgery (BCS) using chest wall perforator flaps (CWPFs) on the subsequent expected deformity and evaluated the longevity of flap volume. METHODS: We retrospectively reviewed oncological and cosmetic outcomes of 33 women who had undergone the above procedure. We calculated the percentage of breast volume excised (PBVE) from computed tomography volumetry and compared it between a historical BCS alone and the study (flap) group...
December 15, 2019: Journal of Surgical Oncology
Giacomo Montagna, Mathilde Ritter, Walter P Weber
One of the most important news occurring in axillary surgery since the last St. Gallen Conference in 2017 was the publication of confirmatory long-term follow-up data from several large multicenter phase III non-inferiority trials, which clearly showed that axillary dissection can no longer be considered standard practice in all node-positive patients. Several groups are currently investigating the most accurate method to reliably determine axillary pathologic complete response after neoadjuvant chemotherapy to omit axillary dissection in initially clinically node-positive patients...
November 2019: Breast: Official Journal of the European Society of Mastology
Cary S Kaufman
PURPOSE OF REVIEW: The goals of surgery for breast cancer have remained the same over the years, to eliminate breast cancer from the breast with the least degree of deformity. With the current expectation of long-term survival after breast cancer treatment, more attention has turned to the cosmetic result of the surgical treatment. Whether lumpectomy or mastectomy, the need for aesthetic improvement was recognized by surgeons both in and outside the USA. RECENT FINDINGS: Oncoplastic surgery combines the skills of the cancer surgeon with those of the plastic surgeon...
December 14, 2019: Current Oncology Reports
Ko Un Park, Kristin Kyrish, Min Yi, Isabelle Bedrosian, Abigail S Caudle, Henry M Kuerer, Kelly K Hunt, Makesha V Miggins, Sarah M DeSnyder
BACKGROUND: Responsible opioid prescribing for postoperative pain control is critical. We sought to identify both patient and surgical factors associated with increased opioid use after breast-conserving surgery (BCS). METHODS: Patients (N = 316) undergoing BCS were surveyed to determine postoperative opioid use. Univariate and multivariate analyses were used to determine factors contributing to increased opioid use (highest quartile of use). All opioid prescriptions were converted to oral morphine equivalents (OME) for analysis...
December 9, 2019: Annals of Surgical Oncology
Christine Radtke
No abstract text is available yet for this article.
October 2019: Breast Care
Liling Zhu, Shunrong Li, Luyuan Tan, Xiaolan Zhang, Jiannan Wu, Fengxi Su, Kai Chen, Erwei Song
No abstract text is available yet for this article.
December 4, 2019: Cancer Communications
Emad M Abdelrahman, Ahmed M Nawar, M Ashraf Balbaa, Ahmed A Shoulah, Ahmed A Shora, Mohamed S Kharoub
Background: Volume replacement oncoplastic breast techniques have become one of the standard lines in the treatment of early breast cancer. They have better cosmetic outcome and patient satisfaction. Latissimus dorsi (LD) flap is one of the most commonly used flaps for these techniques. Although it shows satisfactory surgical outcomes, postoperative shoulder dysfunction is an obvious drawback. The aim of this study was to compare LD flap with thoracodorsal artery perforator (TDAP) flap after breast-conserving surgery regarding surgical outcomes, patient satisfaction, and impact on shoulder function...
October 2019: Plastic and Reconstructive Surgery. Global Open
Chirag Shah, Alvaro Martinez, Matthew Kolar, Frank Vicini
Breast brachytherapy represents a radiation technique that can be utilized as both monotherapy and as a tumor bed boost following breast conserving surgery. As monotherapy, the rationale for brachytherapy is that the majority of residual disease and therefore recurrences occur in close proximity to the lumpectomy cavity; for boost treatment, brachytherapy represents a technique that provided a more conformal approach prior to 3D treatment planning, and more recently can be used in conjunction with oncoplastic surgery...
January 2020: Seminars in Radiation Oncology
Alberto Rancati, Claudio Angrigiani, Julio Dorr, Marcelo Irigo, Maurizio B Nava, Giuseppe Catanuto, Nicola Rocco, Agustin Rancati
Surgical treatment of breast cancer has changed during the last few decades. Long-term evaluation of several studies performed worldwide have confirmed that conservative surgery (CS) and radical mastectomy have similar survival rates. Due to CS being the gold standard for treatment for most women with breast cancer, advances in materials, mastectomy and reconstructive surgery techniques, now give us the possibility to perform on our patients a great outcome with oncological security. Both advances, in plastic and oncologic surgery, created a new discipline, called oncoplastic breast surgery, that allow surgeons to resect large breast specimens preventing subsequent deformities with the correct previous planning...
October 2019: Gland Surgery
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