Abstract
Purpose
To develop an atlas for oncoplastic surgery (OPS) with template dissection techniques via anatomically ideal incisions for breast conservation surgery. The evolution of breast conservation techniques has evolved from placing an incision directly over the lesion to the incorporation of a thoughtful decision making process utilizing oncoplastic surgical (OPS) techniques to combining OPS with incision placement in anatomically advantageous sites. The high survival rates of breast cancer and effect of breast surgery on quality of life reinforce emphasis of optimal oncologic as well as aesthetic outcome. OPS results in greater patient satisfaction, fewer surgeries, and is oncologically safe. Today’s breast surgeon is tasked with optimizing both oncologic and aesthetic outcomes.
Methods
Presentation of reproducible dissection techniques and incision placement strategies to afford surgeons a step-by-step approach of OPS via anatomically ideal incisions in breast conservation surgery.
Results
Demonstration of reproducible techniques to facilitate the decision making process of optimal breast conservation surgery, eliminate knowledge gaps for surgeons, optimize outcome for individuals undergoing breast conservation surgery, and decrease disparity of care.
Conclusion
Adoption of OPS techniques utilizing an anatomically ideal incision in breast conservation surgery is a feasible and reproducible practice for breast surgeons. Application of these techniques results in maintained optimal shape, size, and contour without the typical overlying skin envelope scars. OPS techniques performed under the skin envelope result in expected OPS oncologic and aesthetic outcomes with the addition of the resulting scar(s) in anatomically discrete position(s).
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Abbreviations
- OPS:
-
Oncoplastic surgery
- BCS:
-
Breast conservation surgery
- NAC:
-
Nipple areolar complex
- IMF:
-
Inframammary fold
- RA:
-
Retroareolar
- QOL:
-
Quality of life
- UOQ:
-
Upper-outer quadrant
- SLNBx:
-
Sentinel lymph node biopsy
- AXLND:
-
Axillary lymph node dissection
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Author has received honorarium and stock options from Invuity: participant in Advisory Council, Speaker, and Consultant.
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Mitchell, S.D. A step-by-step oncoplastic breast conservation surgical atlas of reproducible dissection techniques and anatomically ideal incision placement. Breast Cancer Res Treat 165, 505–516 (2017). https://doi.org/10.1007/s10549-017-4344-z
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DOI: https://doi.org/10.1007/s10549-017-4344-z