جستجوی مقالات مرتبط با کلیدواژه « oncoplastic surgery » در نشریات گروه « پزشکی »

The employment of oncoplastic techniques for the treatment of central breast cancer is becoming increasingly popular.

Our study aimed to evaluate the oncological safety of oncoplastic techniques in central breast cancer patients, and to assess resulting breast aesthetics and patient satisfaction.

This descriptive study examined 68 patients with central breast cancer who were operated consecutively between March 2017 and March 2020. Demographic characteristics of the patients, biological characteristics of the tumor, surgical techniques and adjuvant treatments, postoperative complications, and follow-up (oncological, aesthetic, and satisfaction) results were evaluated.

Sixty-eight patients were monitored for an average of 25 months post-operatively. Re-excision was required in 2 (2.9%) cases because of positive surgical margins. Local recurrence ensued in a total of 2 (2.9%) cases, and overall survival was 100%. During the postoperative follow-up period, an independent panel scored breast aesthetics at 76/100, while the patient satisfaction score was obtained at 7.5 on a 9-point Likert-type scale. Complications developed in 10 (14.7%) cases in our series.

According to our study findings, oncoplastic techniques can be considered safe in terms of oncological results for the surgical treatment of central breast cancer. This approach may provide high patient satisfaction.

Treatment of breast cancer (BC) remains a constant and rapidly evolving issue for multidisciplinary breast cancer teams. Considering the emerging understanding and advances in the biological course of this disease, new trends in radiotherapy fractionation, systemic therapies, and oncoplastic surgical techniques are revolutionizing adjuvant treatment approaches to BC. Novel challenges are questioning the integration of adjuvant radiotherapy (ART) into the real-world clinical setting.

PubMed literature search was conducted in order to extract data supporting the role of new trends in breast cancer adjuvant approach according to rising issues in the multidisciplinary team discussion such as sequencing with chemotherapy (CT) plus whole breast hypofractionated radiotherapy (HF-WBRT); the role of ART after neoadjuvant CT (NACT) followed by breast conservative surgery (BCS) in early BC achieving pathological complete remission (pCR); and the integration of ART in immediate autologous breast oncoplastic reconstruction after mastectomy (a-IBR). Furthermore, there are still several concerns about toxicity with adjuvant trastuzumab emtansine (T-DM1) or breast re-irradiation after BCS relapse in long-term survivors refusing mastectomy.

Among 40 hits, only 12 studies answered these issues. Many of them were retrospective studies. Less than 500 patients met the criteria for these issues and several conclusions were found exhaustive.

Few issues seem to have a literature solution, while there are still open questions in regard to these new trends. Novel strategies through prospective or randomized studies and new consensus guidelines are required.

Breast cancer is the most common cancer in women and surgery is necessary for its treatment. We aimed to determine the oncologic outcomes, satisfaction with breasts, and psychosocial well-being in the patients with breast cancer, after oncoplastic and conventional breast conserving surgery (BCS).

The patients with breast cancer from Shahid Motahari Clinic affiliated to Shiraz University of Medical Sciences, Shiraz, Iran from December 2020 to December 2021 were allocated to two groups, one who had undergone BCS alone and the patients who had undergone oncoplastic BCS. For all the patients, demographic data, data about surgery, oncologic outcomes, wound complications, and BREAST-Q© questionnaire score were collected and compared between two groups.

The mean age of the patients in the oncoplastic BCS and BCS group was 48.13±9.73 (median=48), and 50.01±8.47 (median=50) years, respectively. The mean score of psychosocial well-being was higher in the oncoplastic BCS group in comparison with BCS alone. (P-value< 0.0001). Also, the mean score of satisfaction with breast was higher among the oncoplastic BCS group in comparison with the BCS group (P-value< 0.0001).

Replacing traditional BCS with oncoplastic BCS does not adversely affect the oncologic results of surgery but improves the consequent psychosocial well-being and satisfaction in the patients.

Surgical procedures applied in the treatment of early breast cancer (EBC) to achieve satisfactory oncological results lie in a wide spectrum. There has been a major shift toward less-invasive treatments during the past decades. We compared the outcomes of oncoplastic breast surgery (OBS), non-oncoplastic breast conserving surgery (NBCS) and mastectomy in the treatment of EBC.

The records of 412 patients with EBC who underwent OBS, NBCS or mastectomy at our institution between January 2012 and June 2019 were retrospectively analyzed. Postoperative complications, local recurrences (LR) and disease-free survival (DFS) were compared between the groups. EBC patients with unilateral stage-I, IIa and IIb tumors were studied. All patients received adjuvant, targeted and/or endocrine therapy according to the tumor characteristics, followed by radiotherapy (all OBS and NBCS cases, and selected mastectomy patients).

Postoperative complications were similar in all groups except for six fat necrosis and partial nipple-areola necrosis in two diabetic patients treated with OBS. Re-excision rate was lower in OBS (6.5%) than NBCS (8%). There was no statistical difference between the groups regarding recurrence (P=1.000) or DFS (P=0.937).

OBS, NBCS and mastectomy are equally acceptable procedures in EBC in terms of both oncological and surgical aspects.

Although, the lateral thoracodorsal flap is a well described technique, its utility seems to be lost in the ever evolving world of oncoplastic breast surgery. This study reviews the technique, its indications and limitations and the advantage of this technique.

Between January 2016 and January 2018, data from 7 consecutive patients who underwent partial breast mastectomy with lateral thoracodorsal flap were enrolled.  A wedge shaped flap was designed using the pinch test using the index finger and the thumb in small defects, while larger defects required a convex shaped incision with curved superior and inferior borders. Incision was made along the marked margins of the proposed flap and deepened to the underlying serratus anterior and latissimus dorsii muscle. The flap was transposed in the defect and the symmetry of mound between the two breasts confirmed in sitting and supine position.

All patients were satisfied by cosmetic outcomes on visual analog scale (VAS). Cosmetic results based on Harvard scale showed good to excellent scores. Evaluation by Breast Cancer Conservation Treatment (BCCT) core software illustrated good to excellent cosmetic outcomes. There was no delayed wound healing, marginal skin ornecrosis and no evidence of any fat necrosis in the follow up period.

The versatility of latissimus dorsii flap, good aesthetic and functional results and its simple execution made it an important option in the armamentarium of the oncoplastic breast surgeon. Also, morbidity of the donor site was minimized without sacrificing muscles or nerves.

Compared to other breast surgery methods, the accurate determination of pathologic margin in oncoplastic technique can affect its development and further employment of this technique. The current study aimed at evaluating positive pathologic margin after oncoplastic surgery and comparing it to that of the conventional breast-conserving surgery.
The current cross sectional and prospective study enrolled patients with breast cancer referring to the surgical clinic of Tehran Cancer Institute from 2010 to 2013. In this study, patients with breast cancer were evaluated based on the type of surgery (oncoplastic or conventional breast-conserving) they had undergone. Accordingly, the positive or negative result of the margin surgery was compared between the groups.
In the current study, 317 patients with breast cancer underwent the surgery during the study period (154 patients in the oncoplastic and 163 patients in the conventional breast-conserving surgery groups). The highest frequency in the oncoplastic surgery belonged to Omega method (27.3%). The pathological evaluations after surgery showed ductal breast carcinoma in most of the cases in both groups (oncoplastic surgery = 94.2%; conventional breast-conserving surgery = 90.8%; P = 0.053). Positive margin in oncoplastic surgery and conventional breast-conserving surgery groups were 10.4% and 18.4%, respectively (P = 0.043). Among the 317 studied subjects, 14 relapse cases were observed; in 7 cases, mastectomy and in the rest, re-excision were conducted. Two out of 14 cases belonged to the positive margin group.
Using oncoplastic surgery as a method for breast surgery may play an important role in reducing the prevalence of positive margins compared to the conventional breast-conserving surgery.

Phyllodes tumors are biphasic fibroepithelial neoplasms of the breast. While the surgical management of these relatively uncommon tumors has been addressed in the literature, few reports have commented on the surgical approach to tumors greater than ten centimetres in diameter – the giant phyllodes tumor. We report a case of giant breast tumors and discuss the techniques utilized for pre-operative diagnosis, tumor removal, and breast reconstruction. A review of the literature on the surgical management of phyllodes tumors was performed.
Management of the large phyllodes tumors presents the surgeon with unique challenges. The majority of these tumors can be managed by simple mastectomy but reconstruction and even oncoplastic conservative management is for selective consideration.

Oncoplastic breast surgery (OBS) has gained widespread acceptance during the last two decades as an integral component of breast cancer surgery. OBS combines oncological principles of breast cancer surgery with plastic surgery techniques to provide the best cosmetic results without compromising oncological outcome of breast cancer treatment and it has opened up the possibility to perform breast conservation in large tumors.The purpose of this review is assessment of the oncological outcome of OBS in the treatment of breast cancer. We performed an extensive search of PubMed for articles published on oncological results and safety of OBS. There are few randomized clinical trials (RCTs) comparing the results of OBS with standard breast conservation techniques; however, based on the results of several prospective studies, it can be concluded that in terms of oncological outcome, OBS is at least as safe as standard techniques for breast conservation.