Abstract
Breast conserving surgery (BCS) is now a standard surgical treatment for early breast cancer. The number of patients with tumors under 3 cm who underwent breast conserving surgery overtook the number of patients who underwent total mastectomy for the first time in Japan in 2003. We have been employing breast conserving surgery with primary reconstruction using a lateral tissue flap (LTF), and have performed breast conserving surgery for 266 patients from 1990 to 2002. The incidence of local relapse was 5.6%. Although we did not irradiate a low risk group of 101 patients, our method is not inferior to other reports in which all cases underwent irradiation. Primary reconstruction with LTF has three advantages. The first is that we can avoid poly-surgery for breast reconstruction. The second is that the volume of the graft is maintained longer than reconstruction with a musculo-cutaneous flap. The third is that patients can avoid allergic reactions or granulomas as seen with artificial prosthesies. In conclusion, breast conserving surgery with immediate volume replacement with a LTF is a reasonable surgical procedure and has the advantage of avoiding unnecessary surgical procedures for reconstruction and surgical invasion without delaying the diagnosis of local relapse. Moreover, an adequate assessment of risk can spare low risk groups irradiation.
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References
Fisher B, Redmond C, Poissonet al: Eight-year results of a randomized clinical trial comparing total mastectomy and lumpectomy with or without irradiation in the treatment of breast cancer.N Engl J Med 320:822–828, 1989.
Ohuchi N, Breast-Conserving Surgery for Invasive Cancer: A Principle Based on Segmental Anatomy, Tohoku.J Exp Med 188:103–118, 1999.
Ohuchi N, Harada Y, Ishida T, Kiyohara H, Satomi S, Breast-conserving surgery for primary breast cancer: immediate volume replacement using lateral tissue flap.Breast Cancer 4:59–65, 1997.
Amano G, Ohuchi N, Ishibashi T, Ishida T, Amari M, Satomi S: Correlation of three-dimensional magnetic resonance imaging with meticurous histopathologic map concerning carcinoma extension in 58 breast cancer patients.Breast Cancer Res Treat 60:43–55, 2000.
Ishida T, Furuta A, Moriya T, Ohuchi N: Pathological assessment of intraductal spread of carcinoma in relation to surgical margin state in breast conserving surgery.Jpn J Clin Oncol 33:161–166, 2003.
Ikeda T, Akiyama F, Hirata M, Inaji H, Ohuchi N, Takatsuka Y, Yoshimoto M: Surgical Margin Status as a Cause of Local Failure after Breast Conserving Therapy.Breast Cancer 6:93–97, 1999.
van Dongen JA, Bartelink H, Fentiman IS, Lerut T, Mignolet F, Olthuis G, van der Schueren E, Sylvester R, Tong D, Winter J: Factors influencing local relapse and survival and results of salvage treatment after breast-conserving therapy in operable breast cancer: EORTC trial 10801, breast conservation compared with mastectomy in TNM stage I and II breast cancer.Eur J Cancer 28A:801–805, 1992.
Veronesi U, Salvadori B, Luini A, Greco M, Saccozzi R, del Veccio M, Mariani L, Zurrida S, Rilke F: Breast conservation is a safe method in patients with small cancer of the breast. Long-term results of three randomized trials on 1973 patients.Eur J Cancer 31A:1574–1579, 1995.
van Dongen JA, Voogd AC, Fentiman IS, Legrand C, Sylvester RJ, Tong D, van der Schueren E, Helle PA, van Zijl K, Bartelink H: Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy: European Organization for Research and Treatment of Cancer 10801 trial.J Natl Cancer Inst 92:1143–1150, 2000.
Touboul E, Buffat L, Belkacemi Y, Lefranc JP, Uzan S, Lhuillier P, Faivre C, Huart J, Lotz JP, Antoine M, Pene F, Blondon J, Izrael V, Laugier A, Schlienger M, Housset M: Local recurrences and distant metastases after breast-conserving surgery and radiation therapy for early breast cancer.Int J Radiat Oncol Biol Phys 43:25–38, 1999.
Voogd AC, Nielsen M, Peterse JL, Blichert-Toft M, Bartelink H, Overgaard M, van Tienhoven G, Andersen KW, Sylvester RJ, van Dongen JA: Differences in risk factors for local and distant recurrence after breast-conserving therapy or mastectomy for stage I and II breast cancer: pooled results of two large European randomized trials.J Clin Oncol 19:2583, 2001.
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Takeda, M., Ishida, T., Ohnuki, K. et al. Breast conserving surgery with primary volume replacement using a lateral tissue flap. Breast Cancer 12, 16–20 (2005). https://doi.org/10.2325/jbcs.12.16
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DOI: https://doi.org/10.2325/jbcs.12.16