Analysis of Oncoplastic Techniques in Breast Conservative Therapy for Early Breast Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

KANG Hua , ZHU Jiang , HAI Tao , WANG Yajun.

Department of General Surgery, Xuanwu Hospital Capital Medical University, Beijing 100053, China;

Corresponding author：

Keywords：

Breast cancer; Breast conserving surgery; Oncoplastic technique; Cosmetic outcome

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ObjectiveTo evaluate the clinical and cosmetic outcome of patients with early breast cancer underwent oncoplastic techniques in breast conserving surgery. MethodsClinical data of 59 patients with early stage breast cancer who underwent oncoplastic techniques in the breast conserving surgery were analyzed retrospectively from January 2007 to March 2011. Cosmetic outcome score and patient satisfaction questionnaire were also assessed. ResultsThe age of the patients was (53.5±9.8) years (range, 32 to 77 years). The diameter of tumors was (1.6±0.7) cm (range, 0.5 to 4.0 cm). The foci located at upper quadrant in 38, lower quadrant in 17, central area in 4. During operation, single incision approach was used in 25 patients, two incisions approach in 34 patients. A variety of methods were used to repair breast defects including mammary gland direct suture in 9 patients, mammary gland pedicle flaps in 35, local flaps or adipofascial flap in 9, latissimus dorsi myocutaneous flaps in 2, and reduction mammaplasty with “J” or double ring incision in 4. The mean followup period was 30 months (range, 3 to 53 months), no local recurrence was detected. However, bone metastases was found in one patient on 14 months after operation. Fifty-three patients (89.8%) had good to excellent aesthetic results with cosmetic outcome score ≥26. Patient satisfaction questionnaire showed that 40 patients (67.8%) were excellent, 14 (23.7%) good, 3 (5.1%) fair, and 2 (3.4%) poor. ConclusionOncoplastic techniques in the breast conservative therapy for early stage breast cancer is a safe and effective procedure, with highly satisfactory cosmetic outcomes in the majority of patients.

Citation： KANG Hua,ZHU Jiang,HAI Tao,WANG Yajun.. Analysis of Oncoplastic Techniques in Breast Conservative Therapy for Early Breast Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(9): 917-921. doi: Copy

1.	Bajaj AK, Kon PS, Oberg KC, et al. Aesthetic outcomes in patients undergoing breast conservation therapy for the treatment of localized breast cancer [J]. Plast Reconstr Surg, 2004, 114(6): 14421449.
2.	Slavin SA, Halperin T. Reconstruction of the breast conservation deformity [J]. Semin Plast Surg, 2004, 18(2): 8996.
3.	Wang HT, Barone CM, Steigelman MB, et al. Aesthetic outcomes in breast conservation therapy [J]. Aesthet Surg J, 2008, 28(2): 165170.
4.	Veiga DF, Veigafilho J, Ribeiro LM, et al. Qualityoflife and selfesteem outcomes after oncoplastic breastconserving surgery [J]. Plast Reconstr Surg, 2010, 125(3): 811817.
5.	Fitoussi AD, Berry MG, Famà F, et al. Oncoplastic breast surgery for cancer: analysis of 540 consecutive cases [J]. Plast Reconstr Surg, 2010, 125(2): 454462.
6.	Masetti R, Di LA, Franceschini G, et al. Oncoplastic techniques in the conservative surgical treatment of breast cancer:an overview [J]. Breast J, 2006, 12(5 Suppl 2): S174S180.
7.	Fisher B, Anderson S, Bryant J, et al. Twentyyear followup of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer [J]. N Engl J Med, 2002, 347(16): 12331241.
8.	Jatoi I, Proschan MA. Randomized trials of breastconserving therapy versus mastectomy for primary breast cancer: a pooled analysis of updated results [J]. Am J Clin Oncol, 2005, 28(3): 289294.
9.	Margenthaler JA. Optimizing conservative breast surgery [J]. J Surg Oncol, 2011, 103(4): 306312.
10.	Chan SW, Cheung PS, Chueng PS, et al. Cosmetic outcome and percentage of breast volume excision in oncoplastic breast conserving surgery [J]. World J Surg, 2010, 34(7): 14471452.
11.	Taylor ME, Perez CA, Halverson KJ, et al. Factors influencing cosmetic results after conservation therapy for breast cancer [J]. Int J Radiat Oncol Biol Phys, 1995, 31(4): 753764.
12.	Lebovic GS. Oncoplastic surgery:a creative approach to breast cancer management [J]. Surg Oncol Clin N Am, 2010, 19(3): 567580.
13.	Gainer SM, Lucci A. Oncoplastics: techniques for reconstruction of partial breast defects based on tumor location [J]. J Surg Oncol, 2011, 103(4): 341347.
14.	Berry MG, Fitoussi AD, Curnier A, et al. Oncoplastic breast surgery: a review and systematic approach [J]. J Plast Reconstr Aesthet Surg, 2010, 63(8): 12331243.
15.	Tan M, Ung O. Alternative approaches for oncoplastic breast surgery [J]. Ann Surg Oncol, 2011, 18(1): 297299.
16.	Bulstrode NW, Shrotria S. Prediction of cosmetic outcome following conservative breast surgery using breast volume measurements [J]. Breast, 2001, 10(2): 124126.
17.	Law TT, Kwong A. Surgical margins in breast conservation therapy: how much should we excise? [J]. South Med J, 2009, 102(12): 12341237.
18.	Malka I, Villet R, Fitoussi A, et al. Oncoplastic conservative treatment for breast cancer. Part 2. Techniques for the inferior quadrants [J]. J Visc Surg, 2010, 147(5): e305e315.
19.	Kijima Y, Yoshinaka H, Owaki T, et al. Immediate reconstruction using inframammary adipofascial flap of the anterior rectus sheath after partial mastectomy [J]. Am J Surg, 2007, 193(6): 789791.
20.	Zaha H, Sunagawa H, Kawakami K, et al. Partial breast reconstruction for an inferomedial breast carcinoma using an omental flap [J]. World J Surg, 2010, 34(8): 17821787.

1. Bajaj AK, Kon PS, Oberg KC, et al. Aesthetic outcomes in patients undergoing breast conservation therapy for the treatment of localized breast cancer [J]. Plast Reconstr Surg, 2004, 114(6): 14421449.
2. Slavin SA, Halperin T. Reconstruction of the breast conservation deformity [J]. Semin Plast Surg, 2004, 18(2): 8996.
3. Wang HT, Barone CM, Steigelman MB, et al. Aesthetic outcomes in breast conservation therapy [J]. Aesthet Surg J, 2008, 28(2): 165170.
4. Veiga DF, Veigafilho J, Ribeiro LM, et al. Qualityoflife and selfesteem outcomes after oncoplastic breastconserving surgery [J]. Plast Reconstr Surg, 2010, 125(3): 811817.
5. Fitoussi AD, Berry MG, Famà F, et al. Oncoplastic breast surgery for cancer: analysis of 540 consecutive cases [J]. Plast Reconstr Surg, 2010, 125(2): 454462.
6. Masetti R, Di LA, Franceschini G, et al. Oncoplastic techniques in the conservative surgical treatment of breast cancer:an overview [J]. Breast J, 2006, 12(5 Suppl 2): S174S180.
7. Fisher B, Anderson S, Bryant J, et al. Twentyyear followup of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer [J]. N Engl J Med, 2002, 347(16): 12331241.
8. Jatoi I, Proschan MA. Randomized trials of breastconserving therapy versus mastectomy for primary breast cancer: a pooled analysis of updated results [J]. Am J Clin Oncol, 2005, 28(3): 289294.
9. Margenthaler JA. Optimizing conservative breast surgery [J]. J Surg Oncol, 2011, 103(4): 306312.
10. Chan SW, Cheung PS, Chueng PS, et al. Cosmetic outcome and percentage of breast volume excision in oncoplastic breast conserving surgery [J]. World J Surg, 2010, 34(7): 14471452.
11. Taylor ME, Perez CA, Halverson KJ, et al. Factors influencing cosmetic results after conservation therapy for breast cancer [J]. Int J Radiat Oncol Biol Phys, 1995, 31(4): 753764.
12. Lebovic GS. Oncoplastic surgery:a creative approach to breast cancer management [J]. Surg Oncol Clin N Am, 2010, 19(3): 567580.
13. Gainer SM, Lucci A. Oncoplastics: techniques for reconstruction of partial breast defects based on tumor location [J]. J Surg Oncol, 2011, 103(4): 341347.
14. Berry MG, Fitoussi AD, Curnier A, et al. Oncoplastic breast surgery: a review and systematic approach [J]. J Plast Reconstr Aesthet Surg, 2010, 63(8): 12331243.
15. Tan M, Ung O. Alternative approaches for oncoplastic breast surgery [J]. Ann Surg Oncol, 2011, 18(1): 297299.
16. Bulstrode NW, Shrotria S. Prediction of cosmetic outcome following conservative breast surgery using breast volume measurements [J]. Breast, 2001, 10(2): 124126.
17. Law TT, Kwong A. Surgical margins in breast conservation therapy: how much should we excise? [J]. South Med J, 2009, 102(12): 12341237.
18. Malka I, Villet R, Fitoussi A, et al. Oncoplastic conservative treatment for breast cancer. Part 2. Techniques for the inferior quadrants [J]. J Visc Surg, 2010, 147(5): e305e315.
19. Kijima Y, Yoshinaka H, Owaki T, et al. Immediate reconstruction using inframammary adipofascial flap of the anterior rectus sheath after partial mastectomy [J]. Am J Surg, 2007, 193(6): 789791.
20. Zaha H, Sunagawa H, Kawakami K, et al. Partial breast reconstruction for an inferomedial breast carcinoma using an omental flap [J]. World J Surg, 2010, 34(8): 17821787.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of Oncoplastic Techniques in Breast Conservative Therapy for Early Breast Cancer

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