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Oncoplastic Techniques Extend Breast-Conserving Surgery to Patients with Neoadjuvant Chemotherapy Response Unfit for Conventional Techniques

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Abstract

Background

Oncoplastic surgery is extending the role of breast-conserving surgery in an increasing number of patients who are unsuitable for conventional breast-conserving techniques. The aim of this retrospective study was to analyze the surgical approach, oncoplastic surgery guided by bracketing, used in the treatment of patients who required a wide breast tissue excision after neoadjuvant chemotherapy. The parameters evaluated were as follows: margin status, rate of re-excision for positive margin, early ipsilateral recurrence, and cosmetic outcomes.

Methods

A total of 23 patients were treated with an oncoplastic breast-conserving surgery one-stage procedure using volume-replacement (20) and volume-displacement techniques (3). We reviewed medical records, mammograms and magnetic resonance images. Cosmetic assessment was carried out by a mixed panel made up of three women: a general practitioner, a resident general surgeon and a nurse.

Results

All margins were negative and none of the patients had to have a re-excision for positive margins. One ipsilateral local recurrence was observed after a 32-month follow-up period. Cosmetic outcome was good, with an overall score of 8 out of 10.

Conclusions

Oncoplastic techniques extend breast-conserving surgery to patients with neoadjuvant chemotherapy response unfit for conventional techniques. The surgical approach combining oncoplastic techniques with bracketing allows breast-conserving surgery to be performed in these patients.

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References

  1. Mieog JSD, van der Hage JA, van de Velde CJH (2007) Neoadjuvant chemotherapy for operable breast cancer. Br J Surg 94:1189–1200

    Article  PubMed  CAS  Google Scholar 

  2. Boughey JC, Peintinger F, Meric-Bernstam F et al (2006) Impact of preoperative versus postoperative chemotherapy on the extent and number of surgical procedures in patients treated in randomized clinical trials for breast cancer. Ann Surg 224:464–470

    Google Scholar 

  3. Cochrane RA, Valasiadou P, Wilson ARM et al (2003) Cosmesis and satisfaction after breast-conserving surgery correlates with the percentage of breast volume excised. Br J Surg 90:1505–1509

    Article  PubMed  CAS  Google Scholar 

  4. Clough KB, Lewis JS, Couturaud B et al (2003) Oncoplastic techniques allow extensive resections for breast-conserving therapy of breast carcinomas. Ann Surg 237:26–34

    Article  PubMed  Google Scholar 

  5. Goffman TE, Schneider H, Hay K et al (2005) Cosmesis with bilateral mammoreduction for conservative breast cancer treatment. Breast J 11:195–198

    Article  PubMed  Google Scholar 

  6. Huemer GM, Schrenk P, Moser F et al (2005) Oncoplastic techniques allow breast-conserving treatment in centrally located breast cancer. Plast Reconstr Surg 120:390–398

    Article  Google Scholar 

  7. Hernanz F, Regano S, Redondo-Figuero C et al (2007) Oncoplastic breast-conserving surgery: analysis of quadrantectomy and immediate reconstruction with latissimus dorsi flap. World J Surg 31:1934–1940

    Article  PubMed  Google Scholar 

  8. Costa S-D, Eggermann H, Blohmer J-U et al (2007) Primary systemic treatment and oncoplastic breast surgery—influences and principles. Breast Care 2:281–286

    Article  Google Scholar 

  9. Hernanz F, Regaño S, Vega A et al (2006) Needle-wire-guide breast tumor excision. J Surg Oncol 94:165–166

    Article  PubMed  Google Scholar 

  10. Wapnir IL, Wartenberg DE, Greco RS (1999) Three dimensional staging of breast cancer. Breast Cancer Res Treat 41:15–19

    Article  Google Scholar 

  11. Ueda S, Tamaki Y, Yano K et al (2008) Cosmetic outcome and patient satisfaction after skin-sparing mastectomy for breast cancer with immediate reconstruction of the breast. Surgery 143:414–425

    Article  PubMed  Google Scholar 

  12. Kaur N, Petit J-Y, Rietjens M et al (2005) Comparative study of surgical margins in oncoplastic surgery an qudrantectomy in breast cancer. Ann Surg Oncol 12:539–545

    Article  PubMed  Google Scholar 

  13. Giancalone PL, Roger P, Dubon O et al (2006) Lumpectomy vs oncoplastic surgery for breast-conserving therapy of cancer. A prospective study about 99 patients. Ann Chir 13:256–261

    Article  Google Scholar 

  14. Giancalone PL, Roger P, Dubon O et al (2007) Comparative study of the accuracy of breast resection in oncoplastic surgery and quadrantectomy in breast cancer. Ann Surg Oncol 14:605–614

    Article  Google Scholar 

  15. Rainsbury RM (2007) Surgery insight: oncoplastic breast-conserving reconstruction—indications, benefits, choices and outcomes. Nat Clin Pract Oncol 4:657–664

    Article  PubMed  Google Scholar 

  16. Chen AM, Meric-Berstam F, Hunt KK et al (2004) Breast conservation after neoadjuvant chemotherpy: the M.D. Anderson Cancer Center experience. J Clin Oncol 22:2303–2312

    Article  PubMed  Google Scholar 

  17. Petit JY, Garusi C, Greuse M et al (2002) One hundred and eleven cases of breast conservation treatment with simultaneous reconstruction at the European Institute of Oncology (Milan). Tumori 88:41–47

    PubMed  Google Scholar 

  18. Gendy RK, Able JA, Rainsbury RM (2003) Impact of skin-sparing mastectomy with immediate reconstruction and breast-sparing reconstruction with miniflaps on the outcomes of oncoplastic breast surgery. Br J Surg 90:433–439

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Breast Cancer Unit, Hospital Universitario Marqués de Valdecilla, University of Cantabria, Avenida Valdecilla s/n, 39008, Santander, Cantabria, Spain

    Sara Regaño, Fernando Hernanz, Estrella Ortega, Carlos Redondo-Figuero & Manuel Gómez-Fleitas

  2. C/Ría de Solía 10, 3°E, 39610 El Astillero, 39610, El Astillero, Cantabria, Spain

    Sara Regaño

Authors
  1. Sara Regaño
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  2. Fernando Hernanz
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  3. Estrella Ortega
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  4. Carlos Redondo-Figuero
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  5. Manuel Gómez-Fleitas
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Corresponding author

Correspondence to Sara Regaño.

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Regaño, S., Hernanz, F., Ortega, E. et al. Oncoplastic Techniques Extend Breast-Conserving Surgery to Patients with Neoadjuvant Chemotherapy Response Unfit for Conventional Techniques. World J Surg 33, 2082–2086 (2009). https://doi.org/10.1007/s00268-009-0152-x

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  • DOI: https://doi.org/10.1007/s00268-009-0152-x

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