Therapeutic Mammoplasty: Is it a Solution for Treatment of Early Breast Cancer? | ||||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||||
| Article 2, Volume 45, Issue 4, October 2021, Page 201-210 PDF (11.53 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejprs.2021.201628 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Mahmoud Shehata1; Mohamed A. M. Rizk  1; Hesham Fouad* 1; Tarek A Mostafa1; Youssef Hassan2
| ||||
| 1The Departments of General Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt | ||||
| 2The Departments of Plastic & Reconstructive Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt | ||||
| Abstract | ||||
| Conservative breast surgery has become the standard treatment of early stages breast cancer as it provides the same oncological safety as the classic mastectomy, but in many cases, this led to marked breast deformity especially when the resected mass is large or the mass is located in difficult areas as the upper inner breast quadrant. Objective: This study aims to evaluate the oncological and aesthetic outcome of the therapeutic mammoplasty in treating breast cancers located in the upper breast quadrants. Patients and Methods: Oncoplastic excision of breast cancer by doing bilateral inferior pedicle mammoplasty was performed on 50 patients in Assiut University Hospital between 2016 and 2020. This study was performed on patients with early-stage breast cancer located in the upper inner or outer breast quadrants including those who received neoadjuvant chemotherapy. Evaluation of the short-term surgical outcomes including hospital stay, complications, and symmetrization was done. Patient satisfaction and recurrence were also assessed. Results: A total of 50 patients were included in the study. The mean age was 48.7 years and the tumors were located in the upper outer quadrant, upper inner quadrant, and upper breast pole in 35, 8, and 7 patients respectively. The mean operative time was 3.2 hours. Only 12% of patients showed early complications in form of seroma and wound dehiscence. 90% of the patients showed good symmetry and only 10% showed fair symmetry in the last follow-up (18 months postoperative). 94% of our patients were highly satisfied with the aesthetic outcome. We didn’t report any recurrence. Conclusion: This study shows that oncoplastic breast surgery, as the therapeutic mammoplasty, for breast cancers in the upper breast quadrants can achieve equivalent oncological results as the classic breast conservative surgery with advantageous cosmetic outcome and breasts symmetry especially the inferior pedicle mammoplasty technique which led to much better patients’ satisfaction than the conventional conservative surgeries. | ||||
| Keywords | ||||
| Key Words: Mammoplasty; Cancer; Breast | ||||
| References | ||||
|
Campbell E.J. and Romics L.: Oncological safety and cosmetic outcomes in oncoplastic breast conservation surgery, a review of the best level of evidence literature. Breast Cancer: Targets and Therapy, 9: 521, 2017. 2- Bohon C.: Cancer recognition and screening for common breast disorders and malignancy. Obstet. Gynecol. Clin., 44: 257-270, 2017. 3- Ahmed A.R.: HER2 expression is a strong independent predictor of nodal metastasis in breast cancer. J. Egypt Natl. Cancer Institute, 28: 219-227, 2016. 4- Kaufman C.S.: Increasing Role of Oncoplastic Surgery for Breast Cancer. Curr. Oncol. Rep., 21 (12): 111. Published 2019 Dec 14. doi:10.1007/s11912-019-0860-9, 2019. 5- Silverstein M.J., Lagios M.D., Recht A., et al.: Imagedetected breast cancer: State of the art diagnosis and treatment. Journal of the American College of Surgeons, Oct. 1; 201 (4): 586-97, 2005. 6- Douvetzemis S.E. and Kovacs T.: Concept, Principles and Indication of Oncoplastic Breast Surgery: Fashion or Necessity. In Oncoplastic Breast Surgery Techniques for the General Surgeon (pp. 1-33). Springer, Cham., 2020. 7- Shaikh K., Krishnan S. and Thanki R.: Artificial Intelligence in Breast Cancer Early Detection and Diagnosis. Springer International Publishing AG, Dec 4, 2020. 8- Piper M., Peled A.W. and Sbitany H.: Oncoplastic breast surgery: Current strategies. Gland Surg., 4: 154, 2015. 9- McIntosh J. and O'Donoghue J.M.: Therapeutic mammaplasty– a systematic review of the evidence. European Journal of Surgical Oncology (EJSO), Mar 1; 38 (3): 196- 202, 2012. 10- Eichlier C., Kolsch M., Sauerwald A., Bach A., Gluz O. and Warm M.: Lumpectomy versus mastopexy? a postsurgery patient survey. Anticancer Res., 33: 731-736, 2013. 11- Najafi M., Salmon R. and Kaviani A.: Oncological outcome of oncoplastic breast surgery: A review of the literature. Archives of Breast Cancer, Feb. 28: 5-14, 2015. 12- Emiroglu M., Karaali C., Salimoglu S., Sert I. and Aydın C.: Oncoplastic reduction mammoplasty for breast cancer in women with macromastia: Long term aesthetic, functional and satisfaction outcomes. Contemp. Oncol., 20: 256, 2016. 13- Dixon J.M., editor. Breast Surgery: Companion to Specialist Surgical Practice. Elsevier Health Sciences, Jun 22, 2013. 14- Jeevan R., Cromwell D.A., Trivella M., et al.: Reoperation rates after breast conserving surgery for breast cancer among women in England: Retrospective study of hospital episode statistics. BMJ, Jul 12; 345, 2012. 15- Rose M., Manjer J., Ringberg A. and Henry Svensson: Surgical strategy, methods of reconstruction, surgical margins and postoperative complications in oncoplastic breast surgery. Eur. J. Plast. Surg., 37: 205-214, 2014. 16- Tenofsky P.L., Dowell P., Topalovski T. and Helmer S.D.: Surgical, oncologic, and cosmetic differences between oncoplastic and nononcoplastic breast conserving surgery in breast cancer patients. Am. J. Surg., 207: 398-402, 2014. 17- Chen D.R.: An optimized technique for all quadrant oncoplasty in women with small-to medium-sized breasts. Eur. Rev. Med. Pharmacol. Sci., 18: 1748-1754, 2014. 18- Ogawa T.: Usefulness of breast-conserving surgery using the round block technique or modified round block technique in Japanese females. Asian J. Surg., 37: 8-14, 2014. 19- Losken A., Dugal C.S., Styblo T.M. and Carlson G.W.: A meta-analysis comparing breast conservation therapy alone to the oncoplastic technique. Annals of Plastic Surgery, Feb 1; 72 (2): 145-9, 2014. 20- Munhoz A.M., Aldrighi C.M., Montag E., et al.: Outcome analysis of immediate and delayed conservative breast surgery reconstruction with mastopexy and reduction mammaplasty techniques. Annals of Plastic Surgery, Sep. 1; 67 (3): 220-5, 2011. 210 Vol. 45, No. 4 / Therapeutic Mammoplasty 21- Zaha H., Onomura M. and Unesoko M.: A new scarless oncoplastic breastconserving surgery: Modified round block technique. Breast, 22: 1184-1188, 2013. 22- Denewer A., Shahatto F., Elnahas W., Farouk O., Roshdy S. and Khater A.: Therapeutic reduction mammoplasty in large-breasted women with cancer using superior and superomedial pedicles. Breast Cancer, 4: 167, 2012. 23- Bogusevicius A., Cepuliene D. and Sepetauskiene E.: The integrated evaluation of the results of oncoplastic surgery for locally advanced breast cancer. The Breast Journal, Jan. 20 (1): 53-60, 2014. 24- Niinikoski L., Leidenius M.H., Vaara P., Voynov A., Heikkilä P. and Mattson J.: Resection margins and local recurrences in breast cancer: Comparison between conventional and oncoplastic breast conserving surgery. Eur. J. Surg. Oncol., 45: 976-982, 2019. 25- Romics L., Macaskill E.J., Fernandez T., Simpson L., Morrow E. and Pitsinis V.: A population-based audit of surgical practice and outcomes of oncoplastic breast conservations in Scotland - an analysis of 589 patients. Eur. J. Surg. Oncol., 44: 939-944, 2018. 26- Clough K.B., van la Parra R.F., Thygesen H.H., Levy E., Russ E. and Halabi N.M.: Long-term results after oncoplastic surgery for breast cancer: A 10-year follow-up. Ann. Surg., 268: 165-171, 2018. | ||||
|
Statistics Article View: 326 PDF Download: 720 |
||||
