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Breast Oncoplastic Resections: No Innovation Without Evaluation

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Abstract

Oncoplastic breast surgery combines the principles of surgical oncology and plastic surgery to achieve satisfactory cosmetic outcome without jeopardizing oncological safety. Despite innovations in surgical techniques, they were hardly evaluated. We have conducted a case series prospective analysis of 150 breast cancer patients who presented with palpable unilateral breast cancer to our unit between June 2016 and September 2017 assessing aesthetic outcome as well as patients’ satisfaction of different volume displacement oncoplastic surgical techniques. We aimed to use objective as well as subjective tools to evaluate patients’ satisfaction after unilateral oncoplastic volume displacement surgery. Our aesthetic results according to the objective Breast Cancer Conservative Treatment (BCCT) core assessment were excellent in 24% (36 cases), good in 38% (57 cases), fair in 32% (48 cases), and poor in 6% (9 cases). Successful oncoplastic breast surgery not only decreases the need for ipsilateral re-excision as well as shape correction procedures but also leads to better patient satisfaction and favourable outcomes.

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References

  1. Ojala K, Meretoja T, Leidenius M (2017) Aesthetic and functional outcome after breast conserving surgery-comparison between conventional and oncoplastic resection. Eur J Surg Oncol 43(4):658–664

    Article  CAS  Google Scholar 

  2. Keynes G (1981) Breast cancer: a case for conservation. Br Med J (Clin Res Ed) 282(6273):1392. https://doi.org/10.1136/bmj.282.6273.1392-a

    Article  CAS  Google Scholar 

  3. Urban C, Anselmi K, Kuroda F, Schwartz J (2014) Oncoplasty as the standard of care in breast cancer surgery. Eur Oncol Haematol 10(1):43–47. https://doi.org/10.17925/EOH.2014.10.1.43

    Article  Google Scholar 

  4. Audretsch W, Rezai M, Kolotas C, Zamboglou N, Schnabel T, Bojar H (1998) Tumor-specific immediate reconstruction in breast cancer patients. Perspect Plast Surg 11:71–100

    Google Scholar 

  5. Schwartz JD (2018) New approach to oncoplastic breast conservation: combining autologous volume replacement and the wise-pattern mammaplasty. Plast Reconstr Surg Glob Open 6(10):e1987. https://doi.org/10.1097/GOX.0000000000001987

    Article  PubMed  PubMed Central  Google Scholar 

  6. Bajaj AK, Kon PS, Oberg KC et al (2004) Aesthetic outcomes in patients undergoing breast conservation therapy for the treatment of localized breast cancer. Plast Reconstr Surg 114:1442–1449

    Article  Google Scholar 

  7. Cardoso M, Cardoso J, Vrieling C, Macmillan D, Rainsbury D, Heil J et al (2012) Recommendations for the aesthetic evaluation of breast cancer conservative treatment. Breast Cancer Res Treat 135(3):629–637. https://doi.org/10.1007/s10549-012-1978-8

    Article  PubMed  Google Scholar 

  8. Chan SW, Cheung PS, Lam SH (2010) Cosmetic outcome and percentage of breast volume excision in oncoplastic breast conserving surgery. World J Surg 34:1447–1452

    Article  Google Scholar 

  9. Cochrane RA, Valasiadou P, Wilson AR, Al-Ghazal SK, Macmillan RD (2003) Cosmesis and satisfaction after breast-conserving surgery correlates with the percentage of breast volume excised. Br J Surg 90(12):1505–1509

    Article  CAS  Google Scholar 

  10. Sickles EA, D’Orsi CJ, Bassett LW et al (2013) ACR BI-RADS® mammography. In: ACR BI-RADS® atlas, breast imaging reporting and data system. Reston, VA, American College of Radiology

  11. Stanton AL, Krishnan L, Collins CA (2001) Form or function? Part 1. Subjective cosmetic and functional correlates of quality of life in women treated with breast-conserving surgical procedures and radiotherapy. Cancer. 91(12):2273–2281

    Article  CAS  Google Scholar 

  12. Haloua MH, Krekel NM, Jacobs GJ et al (2014) Cosmetic outcome assessment following breast-conserving therapy: a comparison between BCCT.core software and panel evaluation. Int J Breast Cancer 2014:716860–716867. https://doi.org/10.1155/2014/716860

    Article  PubMed  PubMed Central  Google Scholar 

  13. Pires D, Junior O, Valadares C, Andrade R (2017) Training in oncoplastic and reconstructive breast surgery: analysis of training in America and in the European Union with the brazilian reality. Revista Brasileira de Mastologia 27(2):164–171

    Article  Google Scholar 

  14. Campbell EJ, Romics L (2017) Oncological safety and cosmetic outcomes in oncoplastic breast conservation surgery, a review of the best level of evidence literature. Breast Cancer (Dove Med Press) 9:521–530. https://doi.org/10.2147/BCTT.S113742 eCollection 2017

    Article  Google Scholar 

  15. Clough KB, Cuminet J, Fitoussi A, Nos C, Mosseri V (1998) Cosmetic sequelae after conservative treatment for breast cancer: classification and results of surgical correction. Ann Plast Surg 41(5):471–481

    Article  CAS  Google Scholar 

  16. Dahlback C, Manjer J, Rehn M, Ringberg A (2016) Determinants for patient satisfaction regarding aesthetic outcome and skin sensitivity after breast-conserving surgery. World J Surg Oncol 14(1):303

    Article  Google Scholar 

  17. Clough KB, Kaufman GJ, Nos C, Buccimazza I, Sarfati IM (2010) Improving breast cancer surgery: a classification and quadrant per quadrant atlas for oncoplastic surgery. Ann Surg Oncol 17(5):1375–1391

    Article  Google Scholar 

  18. Agrawal A (2019) Oncoplastic breast surgery and radiotherapy-adverse aesthetic outcomes, proposed classification of aesthetic components, and causality attribution. Breast J 25(2):207–218

    Article  Google Scholar 

  19. Ozmen T, Polat AV, Polat AK, Bonaventura M, Johnson R, Soran A (2015) Factors affecting cosmesis after breast conserving surgery without oncoplastic techniques in an experienced comprehensive breast centre. Surgeon 13(3):139–144

    Article  Google Scholar 

  20. Dahlback C, Manjer J, Rehn M, Ringberg A (2017) Patients undergoing breast-conserving surgery can benefit from the opportunity to participate in choosing their surgical technique. World J Surg 41(3):734–741

    Article  Google Scholar 

  21. Santos G, Urban C, Edelweiss MI, Zucca-Matthes G, de Oliveira VM, Arana GH et al (2015) Long-term comparison of aesthetical outcomes after Oncoplastic surgery and lumpectomy in breast cancer patients. Ann Surg Oncol 22:2500–2508. https://doi.org/10.1245/s10434-014-4301-6

    Article  PubMed  Google Scholar 

  22. Tournieux T (2012) Predictive factors of good aesthetic results in conservative surgery for breast cancer. Rev Bras Cir Plást 7(1):37–48. https://doi.org/10.1590/S1983-51752012000100008

    Article  Google Scholar 

  23. Ewertz M, Jensen AB (2011) Late effects of breast cancer treatment and potentials for rehabilitation. Acta Oncol 50(2):187–193. https://doi.org/10.3109/0284186X.2010.533190

    Article  PubMed  Google Scholar 

  24. Yazar SK, Altınel D, Serin M, Aksoy Ş, Yazar M (2018) Oncoplastic breast conserving surgery: aesthetic satisfaction and oncological outcomes. Eur J Breast Health 14(1):35–38. https://doi.org/10.5152/ejbh.2017.3512

    Article  PubMed  PubMed Central  Google Scholar 

  25. Foersterling E, Golatta M, Hennigs A, Schulz S, Rauch G, Schott S, Domschke C, Schuetz F, Sohn C, Heil J (2014) Predictors of early poor aesthetic outcome after breast-conserving surgery in patients with breast cancer: initial results of a prospective cohort study at a single institution. J Surg Oncol 110(7):801–806. https://doi.org/10.1002/jso.23733 Epub 2014 Aug 8

    Article  PubMed  Google Scholar 

  26. Yu T, Eom K, Jang N, Kim K, Koo T, Kwon J et al (2016) Objective measurement of cosmetic outcomes of breast conserving therapy using BCCT.core. Cancer Res Treat 48(2):491–498

    Article  Google Scholar 

  27. Nohara Y, Hanamura N, Zaha H, Kimura H, Kashikura Y, Nakamura T (2015) Cosmetic evaluation methods adapted to Asian patients after breast-conserving surgery and examination of the necessarily elements for cosmetic evaluation. J Breast Cancer 18(1):80–86

    Article  Google Scholar 

  28. Dahlbäck C, Ullmark J, Rehn M, Ringberg A, Manjer J (2017) Aesthetic result after breast-conserving therapy is associated with quality of life several years after treatment. Swedish women evaluated with BCCT.core and BREAST-Q™. Breast Cancer Res Treat 164(3):679–687

    Article  Google Scholar 

  29. Peek MC, Kovacs T, Baker R, Hamed H, Kothari A, Douek M (2016) Is blue dye still required during sentinel lymph node biopsy for breast cancer? Ecancer Med Sci 10:674. https://doi.org/10.3332/ecancer.2016.674

    Article  Google Scholar 

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Authors and Affiliations

Authors

Contributions

MI and MF were responsible for the surgery and ongoing patient care and provided the data as well as result analysis. SM researched, drafted, and conceived the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sherif Monib.

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The authors declare that there are no conflicts of interest.

Ethical Approval

No ethical approval was needed for this study as it was an analysis of standard practice.

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Written informed consent was obtained from the patient to include images in the article.

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Monib, S., Farag, M. & Ibrahim, M. Breast Oncoplastic Resections: No Innovation Without Evaluation. Indian J Surg 83 (Suppl 2), 409–415 (2021). https://doi.org/10.1007/s12262-020-02542-y

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  • DOI: https://doi.org/10.1007/s12262-020-02542-y

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