Skip to main content

Advertisement

SpringerLink
Log in

Advanced Locoregional Therapies in Breast

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Advanced locoregional therapies continue to advance the treatment of breast cancer. These techniques are geared towards optimizing oncologic and aesthetic outcome as well as decreasing and treating morbidity. We present a selection of specialized locoregional therapies dedicated to the optimization of breast cancer treatment.

Methods

Locoregional therapies for breast cancer are presented to address breast conservation techniques, lipofilling techniques, reconstruction techniques for nipple-sparing mastectomy, re-irradiating the breast, axillary reverse mapping, and vascularized lymph node transfer.

Results

We present a synopsis of identified breast locoregional therapies targeted to address optimal oncologic and aesthetic outcome as well as decrease and treat morbidity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Gruber RP, Jones HW Jr. The “donut” mastopexy: indications and complications. Plast Reconstr Surg. 1980;65(1):34–8.

    Article  PubMed  CAS  Google Scholar 

  2. Baran CN, Peker F, Ortak T, Sensöz O, Baran NK. Unsatisfactory results of periareolar mastopexy with or without augmentation and reduction mammoplasty: enlarged areola with flattened nipple. Aesthetic Plast Surg. 2001;25(4):286–9.

    Article  PubMed  CAS  Google Scholar 

  3. Benelli L. A new periareolar mammaplasty: the “round block” technique. Aesthetic Plast Surg. 1990;14(2):93–100.

    Article  PubMed  CAS  Google Scholar 

  4. Benelli L. Periareolar Benelli mastopexy and reduction: the round block. In: Spear SL, Willey SC, Robb GL, Hammond DC, Nahabedian MY (eds) Surgery of the breast: principles and art, 2nd edn, vol 2, section III, pp 977-990.

  5. Chakravorty A, Shrestha AK, Sanmugalingam N, Rapisarda F, Roche N, Querci Della Rovere G, Macneill FA. How safe is oncoplastic breast conservation? Comparative analysis with standard breast conserving surgery. Eur J Surg Oncol. 2012;38(5):395–8.

    Article  PubMed  CAS  Google Scholar 

  6. Giacalone PL, Dubon O, Roger P, El Gareh N, Rihaoui S, Daurés JP. Doughnut mastopexy lumpectomy versus standard lumpectomy in breast cancer surgery: a prospective study. Eur J Surg Oncol. 2007.

  7. Kim MK, Kim J, Jung SP, Bae SY, Choi MY, Lee SK, Kim S, Kil WH, Kim SW, Kim JH, Kim JS, Nam SJ, Lee JE. Round block technique without cerclage in breast-conserving surgery. Ann Surg Oncol. 2013;20(10):3341

    Article  PubMed  Google Scholar 

  8. Ogawa T. Usefulness of breast-conserving surgery using the round block technique or modified round block technique in Japanese females. Asian J Surg. 2014;37(1):8–14.

    Article  PubMed  Google Scholar 

  9. Zaha H, Onomura M, Unesoko M. A new scarless oncoplastic breast-conserving surgery: modified round block technique. Breast. 2013;22(6):1184–8.

    Article  PubMed  Google Scholar 

  10. Rubin JP, Coon D, Zuley M, et al. Mammographic changes after fat transfer to the breast compared with changes after breast reduction: a blinded study. Plast Reconstr Surg. 2012;129:1029–38.

    Article  PubMed  CAS  Google Scholar 

  11. Kanchwala SK, Glatt BS, Conant EF, et al. Autologous fat grafting to the reconstructed breast the management of acquired contour deformities. Plast Reconstr Surg. 2009;124:409–18.

    Article  PubMed  CAS  Google Scholar 

  12. “2012 Post-Mastectomy Fat Graft/Fat Transfer ASPS guiding principals.” American Society of Plastic Surgeons, 01 Dec 2012.

  13. Ribuffo D, Atzeni M, Guerra M, et al. Treatment of irradiated expanders: Protective lipofilling allows immediate prosthetic breast reconstruction in the setting of postoperative radiotherapy. Aesth Plast Surg. 2013;37:1146–52.

    Article  Google Scholar 

  14. Serra-Renom JM, Munoz-Olmo JL, Serra-Mestre JM. Fat grafting in postmastectomy breast reconstruction with expanders and prostheses in patients who have received radiotherapy: formation of new subcutaneous tissue. Plast Reconstr Surg. 2010;125:12–8.

    Article  PubMed  CAS  Google Scholar 

  15. Coleman SR. Structural fat grafting: the ideal filler? Clin Plast Surg. 2001;28(1):111–9.

    PubMed  CAS  Google Scholar 

  16. Pinilla S, et al. Tissue resident stem cells produce CCL5 under the influence of cancer cells and thereby promote breast cancer cell invasion. Cancer Letters. 2009;284:80–5.

    Article  PubMed  CAS  Google Scholar 

  17. Muehlberg FL, et al. Tissue resident stem cells promote breast cancer growth and metastasis. Carcinogenesis. 2009;30(4):589–97.

    Article  PubMed  CAS  Google Scholar 

  18. Petit JY Botteri E, Lohsiriwat V, et al. Locoregional recurrence risk after lipofilling in breast cancer patients. Ann Oncol. 2012;23(3):582–8.

    Article  PubMed  CAS  Google Scholar 

  19. Petit JY, et al. Evaluation of fat grafting safety in patients with intraepithelial neoplasia: a matched-cohort study. Ann Oncol. 2013;24:1479–84.

    Article  PubMed  CAS  Google Scholar 

  20. Salgarello M, Visconti G, Barone-Adesi L. Nipple-sparing mastectomy with immediate implant reconstruction: cosmetic outcomes and technical refinements. Plast Reconstr Surg. 2010;126:1460–71.

    Article  PubMed  CAS  Google Scholar 

  21. Djohan R, Gage E, Gatherwright J, Pavri S, Firouz J, Bernard S, Yetman R. Patient satisfaction following nipple-sparing mastectomy and immediate breast reconstruction: an 8-year outcome study. Plast Reconstr Surg. 2010;125:818–29.

    Article  PubMed  CAS  Google Scholar 

  22. Laronga C, Lewis JD, Smith PD. The changing face of mastectomy: an oncologic and cosmetic perspective. Cancer Control. 2012;19:286–294.

    PubMed  Google Scholar 

  23. Moyer HR, Ghazi B, Daniel JR, Gasgarth R, Carlson GW. Nipple-sparing mastectomy: technical aspects and aesthetic outcomes. Ann Plast Surg. 2012;68:446–50.

    Article  PubMed  CAS  Google Scholar 

  24. Crowe JP, et al. Nipple-sparing mastectomy: technique and results of 54 procedures. Arch Surg. 2004;139:148–50.

    Article  PubMed  Google Scholar 

  25. Gould DJ, Hunt KK, Liu J, Kuerer HM, Crosby MA, Babiera G, Kronowitz SJ. Impact of surgical techniques, biomaterials, and patient variables on rate of nipple necrosis after nipple-sparing mastectomy. Plast Reconstr Surg. 2013;132:330–8.

    Article  Google Scholar 

  26. Lee KT, Pyon JK, Bang SI, Lee JE, Nam SJ, Mun GH. Does the reconstruction method influence development of mastectomy flap complications in nipple-sparing mastectomy? J Plast Reconstr Aesth Surg. 2013;66:1543–50.

    Article  Google Scholar 

  27. Endara M, Chen D, Verma K, Nahabedian MY, Spear SL. Breast reconstruction following nipple-sparing mastectomy: a systematic review of the literature with pooled analysis. Plast Reconstr Surg. 2013;132:1043–54.

    Article  PubMed  CAS  Google Scholar 

  28. Stolier AJ, Levine EA (2013) Reducing the risk of nipple necrosis: technical observations in 340 nipple-sparing mastectomies. Breast J. 2013;19:173–9.

    Article  PubMed  Google Scholar 

  29. Keller A. Noninvasive tissue oximetry for flap monitoring: an initial study. J Reconst Microsurg. 2007;23:189–97.

    Article  Google Scholar 

  30. Phillips BT, et al. Intraoperative perfusion techniques can accurately predict mastectomy skin flap necrosis in breast reconstruction: results of a prospective trial. Plast Reconstr Surg. 2012;129:778e–88e.

    Article  PubMed  Google Scholar 

  31. Salibian AH, Harness JK, Mowlds DS (2013) Inframammary approach to nipple-areola–sparing mastectomy. Plast Reconstr Surg. 2013;132:700e–8e.

    Article  PubMed  CAS  Google Scholar 

  32. Tanna N, Broer PN, Weichman KE, Alperovich M, Ahn CY, Allen RJ, Choi M, Karp N, Saadeh PB, Levine JP. Microsurgical breast reconstruction for nipple-sparing mastectomy. Plastic Reconstr Surg. 2013;131:139e–47e.

    Article  CAS  Google Scholar 

  33. Jensen JA, et al. Surgical delay of the nipple-areolar complex: A powerful technique to maximize nipple viability following nipple sparing mastectomy. Ann Surg Oncol. 12(10)3171–6.

  34. Giuliano AE, Hunt KK, Ballman KV, et al. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA. 2011;305(6):569–75.

    Article  PubMed  CAS  Google Scholar 

  35. Thompson M, Korourian S, Henry-Tillman R, et al. Axillary reverse mapping (ARM): a new concept to identify and enhance lymphatic preservation. Ann Surg Oncol. 2007;14(6):1890–5.

    Article  PubMed  Google Scholar 

  36. Boneti C, Korourian S, Diaz Z, et al. Scientific Impact Award: axillary reverse mapping (ARM) to identify and protect lymphatics draining the arm during axillary lymphadenectomy. Am J Surg. 2009;198(4):482–7.

    Article  PubMed  Google Scholar 

  37. Althubaiti GA, Crosby MA, Chang DW. Vascularized supraclavicular lymph node transfer for lower extremity lymphedema treatment. Plast Reconstr Surg. 2013;131(1):133e–5e.

    Article  PubMed  CAS  Google Scholar 

  38. Becker C, Assouad J, Riquet M, et al. Long-term results following microsurgical lymph node transplantation. Ann Surg. 2006;243(3):313–5.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Lin CH, Ali R, Chen SC, et al. Vascularized groin lymph node transfer using the wrist as a recipient site for management of postmastectomy upper extremity lymphedema. Plast Reconstr Surg. 2009;123:1265–75.

    Article  PubMed  CAS  Google Scholar 

  40. Saaristo AM, Niemi TS, Vittanen T, et al. Microvascular reconstruction and lymph node transfer for postmastectomy lymphedema patients. Ann Surg. 2012;255(3):468–73.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Breast Surgery, White Plains Hospital, White Plains, NY, USA

    Sunny Mitchell MD

  2. Department of Breast Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    V. Suzanne Klimberg MD & Daniela Ochoa MD

  3. Department of Surgery, Royal Marsden Hospital, Sutton, Surrey, UK

    Jennifer Rusby MD

  4. Department of Plastic Surgery, The University of Chicago, Chicago, IL, USA

    David Chang MD & Julie Park MD

  5. Department of Radiation Therapy, Good Samaritan Hospital, Pleasanton, CA, USA

    Rakesh Patel MD

  6. Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA

    Jason M. Korn MD & Risal Djohan MD

  7. Columbia University College of Physicians & Surgeons, New York, NY, USA

    Sunny Mitchell MD

Authors
  1. Sunny Mitchell MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. V. Suzanne Klimberg MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Daniela Ochoa MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jennifer Rusby MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. David Chang MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Rakesh Patel MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Julie Park MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jason M. Korn MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Risal Djohan MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sunny Mitchell MD.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mitchell, S., Klimberg, V.S., Ochoa, D. et al. Advanced Locoregional Therapies in Breast. Ann Surg Oncol 21, 3198–3203 (2014). https://doi.org/10.1245/s10434-014-3916-y

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-014-3916-y

Keywords

Search

Navigation