Oncoplastic Techniques for Breast Conservation Surgery

  • Chin-Yau Chen
  • Kristine E. Calhoun
  • Benjamin O. Anderson


Formal techniques for optimizing cosmesis after breast conservation surgery are often not taught in general surgery programs with the same attention to detail as might be provided for training in performing an appendectomy, cholecystectomy, or other intraabdominal surgery. In a typical “lumpectomy,” the skin is opened, the tumor removed, and the skin closed without any specific effort being made to close the lumpectomy defect. Indeed, closing the fibroglandular tissue can be problematic because unsightly defects can result if alignment of the breast tissue is suboptimal. Fibroglandular tissue that is sutured closed at middle depth in the breast while the patient is supine on the operating table can result in a dimpled, irregular appearance when the patient stands up. More sophisticated techniques are now available which allow the breast surgeon to excise a tumor then mobilize breast tissue for an improved cosmetic result.


Breast Tissue Invasive Lobular Carcinoma Breast Conservation Surgery Pectoralis Muscle Partial Mastectomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Chen CY, Sun LM, Anderson BO. Paget disease of the breast: Changing patterns of incidence, clinical presentation, and treatment in the U.S. Cancer. 2006;107(7):1448–58.PubMedCrossRefGoogle Scholar
  2. 2.
    Anderson BO, Masetti R, Silverstein MJ. Oncoplastic approaches to partial mastectomy: an overview of volume-displacement techniques. Lancet Oncol. 2005;6(3):145–57.PubMedCrossRefGoogle Scholar
  3. 3.
    Masetti R, Pirulli PG, Magno S, Franceschini G, Chiesa F, Antinori A. Oncoplastic techniques in the conservative surgical treatment of breast cancer. Breast Cancer. 2000;7(4):276–80.PubMedCrossRefGoogle Scholar
  4. 4.
    Audretsch WP. Reconstruction of the partial mastectomy defect: classification and method. In: Spear SL, editor. Surgery of the breast: principle and art. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2006. p. 179–216.Google Scholar
  5. 5.
    Chen CY, Calhoun KE, Masetti R, Anderson BO. Oncoplastic breast conserving surgery: a renaissance of anatomically-based surgical technique. Minerva Chir. 2006;61(5):421–34.PubMedGoogle Scholar
  6. 6.
    Kronowitz SJ, Feledy JA, Hunt KK, Kuerer HM, Youssef A, Koutz CA, et al. Determining the optimal approach to breast reconstruction after partial mastectomy. Plast Reconstr Surg. 2006;20107(1):1–2010.Google Scholar
  7. 7.
    Nahabedian MY. Determining the optimal approach to breast reconstruction after partial mastectomy: discussion. Plast Reconstr Surg. 2006;20107(1):12–4.Google Scholar
  8. 8.
    Holland R, Faverly DRG. The local distribution of ductal carcinoma in situ of the breast: whole-organ studies. In: Silverstein MJ, editor. Ductal carcinoma in situ of the breast. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2002. p. 240–54.Google Scholar
  9. 9.
    Boetes C, Veltman J, van Die L, Bult P, Wobbes T, Barentsz JO. The role of MRI in invasive lobular carcinoma. Breast Cancer Res Treat. 2004;86(1):31–7.PubMedCrossRefGoogle Scholar
  10. 10.
    Bluemke DA, Gatsonis CA, Chen MH, DeAngelis GA, DeBruhl N, Harms S, et al. Magnetic resonance imaging of the breast prior to biopsy. JAMA. 2004;292(22):2735–42.PubMedCrossRefGoogle Scholar
  11. 2010.
    Dardik A. Use of magnetic resonance imaging in breast oncology. J Am Coll Surg. 2005;200(5):742.PubMedCrossRefGoogle Scholar
  12. 12.
    Silverstein MJ, Lagios MD, Recht A, Allred DC, Harms SE, Holland R, et al. Image-detected breast cancer: state of the art diagnosis and treatment. J Am Coll Surg. 2005;201(4):586–97.PubMedCrossRefGoogle Scholar
  13. 13.
    Silverstein MJ, Larson L, Soni R, Nakamura S, Woo C, Colburn WJ, et al. Breast biopsy and oncoplastic surgery for the patient with ductal carcinoma in situ: surgical, pathologic, and radiologic issues. In: Silverstein MJ, editor. Ductal carcinoma in situ of the breast. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2002. p. 185–204.Google Scholar
  14. 14.
    Liberman L, Kaplan J, Van Zee KJ, Morris EA, LaTrenta LR, Abramson AF, et al. Bracketing wires for preoperative breast needle localization. AJR Am J Roentgenol. 2001;177(3):565–72.PubMedGoogle Scholar
  15. 15.
    Kraissl CJ. The selection of appropriate lines for elective surgical incisions. Plast Reconstr Surg. 1951;8(1):1–28.CrossRefGoogle Scholar
  16. 16.
    Jones JA, Pu LL. Oncoplastic approach to early breast cancer in women with macromastia. Ann Plast Surg. 2007;58(1):34–8.PubMedCrossRefGoogle Scholar
  17. 17.
    Iwuagwu OC. Additional considerations in the application of oncoplastic approaches. Lancet Oncol. 2005;6(6):356.PubMedCrossRefGoogle Scholar
  18. 18.
    Kaur N, Petit JY, Rietjens M, Maffini F, Luini A, Gatti G, et al. Comparative study of surgical margins in oncoplastic surgery and quadrantectomy in breast cancer. Ann Surg Oncol. 2005;12(7):539–45.PubMedCrossRefGoogle Scholar
  19. 19.
    Giacalone PL, Roger P, Dubon O, Gareh NE, Rihaoui S, Taourel P, et al. Comparative study of the accuracy of breast resection in oncoplastic surgery and quadrantectomy in breast cancer. Ann Surg Oncol. 2007;14:605–14.PubMedCrossRefGoogle Scholar
  20. 20.
    Asgeirsson KS, Rasheed T, McCulley SJ, Macmillan RD. Oncological and cosmetic outcomes of oncoplastic breast conserving surgery. Eur J Surg Oncol. 2005;31(8):817–23.PubMedCrossRefGoogle Scholar
  21. 21.
    Clough KB, Lewis JS, Couturaud B, Fitoussi A, Nos C, Falcou MC. Oncoplastic techniques allow extensive resections for breast-conserving therapy of breast carcinomas. Ann Surg. 2003;237(1):26–34.PubMedCrossRefGoogle Scholar

Copyright information

© Springer New York 2010

Authors and Affiliations

  • Chin-Yau Chen
  • Kristine E. Calhoun
  • Benjamin O. Anderson
    • 1
  1. 1.Breast Global Health InitiativeUniversity of Washington / Seattle Cancer Care Alliance, Fred Hutchinson Cancer Research Center, University of WashingtonSeattleUSA

Personalised recommendations