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Published in: European Journal of Plastic Surgery 5/2016

Open Access 01-10-2016 | Review

Assessment and planning for oncoplastic and reconstructive breast surgery: a review and a proposed chart

Author: Amit Agrawal

Published in: European Journal of Plastic Surgery | Issue 5/2016

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Abstract

Assessment for oncoplastic and reconstructive breast surgery (ORBS) can be time-consuming and subjective with a prolonged learning curve. Further, lack of recognition of options may lead to loss of patient choices whether available locally or not. This article reviews and incorporates essential variables into an author-designed chart with components of clinic consultation (“History” and “Examination”) that classify individual cases into one of the three complexities: high, average and low. Based on these complexities, decision-making processes are discussed in order to achieve, safely and realistically, both subjective and objective (anticipated versus achieved) goals of ORBS. This article by summarising literature around common ORBS variables attempts to streamline decision-making process as well as charts out variables to facilitate audit of decision-making and case selection process.
Level of Evidence: Not ratable
Literature
2.
go back to reference Mukesh M, Harris E, Jena R, Evans P, Coles C (2012) Relationship between irradiated breast volume and late normal tissue complications: a systematic review. Radiother Oncol 104(1):1–10CrossRefPubMed Mukesh M, Harris E, Jena R, Evans P, Coles C (2012) Relationship between irradiated breast volume and late normal tissue complications: a systematic review. Radiother Oncol 104(1):1–10CrossRefPubMed
3.
go back to reference Mukesh MB, Barnett G, Cumming J et al (2012) Association of breast tumour bed seroma with post-operative complications and late normal tissue toxicity: results from the Cambridge Breast IMRT trial. Eur J Surg Oncol 38(10):918–924CrossRefPubMed Mukesh MB, Barnett G, Cumming J et al (2012) Association of breast tumour bed seroma with post-operative complications and late normal tissue toxicity: results from the Cambridge Breast IMRT trial. Eur J Surg Oncol 38(10):918–924CrossRefPubMed
4.
go back to reference Salzberg CA, Ashikari AY, Koch RM, Chabner-Thompson E (2011) An 8-year experience of direct-to-implant immediate breast reconstruction using human acellular dermal matrix (AlloDerm). Plast Reconstr Surg 127(2):514–524CrossRefPubMed Salzberg CA, Ashikari AY, Koch RM, Chabner-Thompson E (2011) An 8-year experience of direct-to-implant immediate breast reconstruction using human acellular dermal matrix (AlloDerm). Plast Reconstr Surg 127(2):514–524CrossRefPubMed
5.
go back to reference Israeli R, Feingold RS (2011) Acellular dermal matrix in breast reconstruction in the setting of radiotherapy. Aesthet Surg J 31(7 Suppl):51S–64SCrossRefPubMed Israeli R, Feingold RS (2011) Acellular dermal matrix in breast reconstruction in the setting of radiotherapy. Aesthet Surg J 31(7 Suppl):51S–64SCrossRefPubMed
6.
go back to reference Schmitz M, Bertram M, Kneser U, Keller AK, Horch RE (2013) Experimental total wrapping of breast implants with acellular dermal matrix: a preventive tool against capsular contracture in breast surgery? J Plast Reconstr Aesthet Surg 66(10):1382–1389CrossRefPubMed Schmitz M, Bertram M, Kneser U, Keller AK, Horch RE (2013) Experimental total wrapping of breast implants with acellular dermal matrix: a preventive tool against capsular contracture in breast surgery? J Plast Reconstr Aesthet Surg 66(10):1382–1389CrossRefPubMed
7.
go back to reference Stump A, Holton LH 3rd, Connor J, Harper JR, Slezak S, Silverman RP (2009) The use of acellular dermal matrix to prevent capsule formation around implants in a primate model. Plast Reconstr Surg 124(1):82–91CrossRefPubMed Stump A, Holton LH 3rd, Connor J, Harper JR, Slezak S, Silverman RP (2009) The use of acellular dermal matrix to prevent capsule formation around implants in a primate model. Plast Reconstr Surg 124(1):82–91CrossRefPubMed
8.
go back to reference Myckatyn TM, Cavallo JA, Sharma K et al (2015) The impact of chemotherapy and radiation therapy on the remodeling of acellular dermal matrices in staged, prosthetic breast reconstruction. Plast Reconstr Surg 135(1):43e–57eCrossRefPubMedPubMedCentral Myckatyn TM, Cavallo JA, Sharma K et al (2015) The impact of chemotherapy and radiation therapy on the remodeling of acellular dermal matrices in staged, prosthetic breast reconstruction. Plast Reconstr Surg 135(1):43e–57eCrossRefPubMedPubMedCentral
9.
go back to reference Taghizadeh R, Moustaki M, Harris S, Roblin P, Farhadi J (2015) Does post-mastectomy radiotherapy affect the outcome and prevalence of complications in immediate DIEP breast reconstruction? A prospective cohort study. J Plast Reconstr Aesthet Surg 68(10):1379–85CrossRefPubMed Taghizadeh R, Moustaki M, Harris S, Roblin P, Farhadi J (2015) Does post-mastectomy radiotherapy affect the outcome and prevalence of complications in immediate DIEP breast reconstruction? A prospective cohort study. J Plast Reconstr Aesthet Surg 68(10):1379–85CrossRefPubMed
10.
go back to reference Hamdi M, Larsen M, Craggs B, Vanmierlo B, Zeltzer A (2014) Harvesting free abdominal perforator flaps in the presence of previous upper abdominal scars. J Plast Reconstr Aesthet Surg 67(2):219–225CrossRefPubMed Hamdi M, Larsen M, Craggs B, Vanmierlo B, Zeltzer A (2014) Harvesting free abdominal perforator flaps in the presence of previous upper abdominal scars. J Plast Reconstr Aesthet Surg 67(2):219–225CrossRefPubMed
11.
go back to reference Teunis T, van Voss MR H, Kon M, van Maurik JF (2013) CT-angiography prior to DIEP flap breast reconstruction: a systematic review and meta-analysis. Microsurgery 33(6):496–502CrossRefPubMed Teunis T, van Voss MR H, Kon M, van Maurik JF (2013) CT-angiography prior to DIEP flap breast reconstruction: a systematic review and meta-analysis. Microsurgery 33(6):496–502CrossRefPubMed
12.
go back to reference Keys KA, Louie O, Said HK, Neligan PC, Mathes DW (2013) Clinical utility of CT angiography in DIEP breast reconstruction. J Plast Reconstr Aesthet Surg 66(3):e61–65CrossRefPubMed Keys KA, Louie O, Said HK, Neligan PC, Mathes DW (2013) Clinical utility of CT angiography in DIEP breast reconstruction. J Plast Reconstr Aesthet Surg 66(3):e61–65CrossRefPubMed
13.
go back to reference Cina A, Barone-Adesi L, Rinaldi P et al (2013) Planning deep inferior epigastric perforator flaps for breast reconstruction: a comparison between multidetector computed tomography and magnetic resonance angiography. Eur Radiol 23(8):2333–2343CrossRefPubMed Cina A, Barone-Adesi L, Rinaldi P et al (2013) Planning deep inferior epigastric perforator flaps for breast reconstruction: a comparison between multidetector computed tomography and magnetic resonance angiography. Eur Radiol 23(8):2333–2343CrossRefPubMed
14.
go back to reference Patel KM, Basci D, Nahabedian MY (2013) Multiple pregnancies following deep inferior epigastric perforator (DIEP) flap breast reconstruction. J Plast Reconstr Aesthet Surg 66(3):434–436CrossRefPubMed Patel KM, Basci D, Nahabedian MY (2013) Multiple pregnancies following deep inferior epigastric perforator (DIEP) flap breast reconstruction. J Plast Reconstr Aesthet Surg 66(3):434–436CrossRefPubMed
15.
go back to reference Ibrahim AM, Shuster M, Koolen PG et al (2013) Analysis of the National Surgical Quality Improvement Program database in 19,100 patients undergoing implant-based breast reconstruction: complication rates with acellular dermal matrix. Plast Reconstr Surg 132(5):1057–1066CrossRefPubMed Ibrahim AM, Shuster M, Koolen PG et al (2013) Analysis of the National Surgical Quality Improvement Program database in 19,100 patients undergoing implant-based breast reconstruction: complication rates with acellular dermal matrix. Plast Reconstr Surg 132(5):1057–1066CrossRefPubMed
16.
go back to reference Robert G, Duhamel A, Alet JM, Pelissier P, Pinsolle V (2014) Complications of breast reduction about 715 breasts. Ann Chir Plast Esthet 59(2):97–102CrossRefPubMed Robert G, Duhamel A, Alet JM, Pelissier P, Pinsolle V (2014) Complications of breast reduction about 715 breasts. Ann Chir Plast Esthet 59(2):97–102CrossRefPubMed
17.
go back to reference Agrawal A, Sibbering DM, Courtney CA (2013) Skin sparing mastectomy and immediate breast reconstruction: a review. Eur J Surg Oncol 39(4):320–328CrossRefPubMed Agrawal A, Sibbering DM, Courtney CA (2013) Skin sparing mastectomy and immediate breast reconstruction: a review. Eur J Surg Oncol 39(4):320–328CrossRefPubMed
18.
go back to reference Lutringer J, Flipo B, Carles M, Gal J, Chignon-Sicard B (2012) Functional impairment and its impact on sporting activities after latissimus dorsi flap breast reconstruction. Ann Chir Plast Esthet 57(6):567–574CrossRefPubMed Lutringer J, Flipo B, Carles M, Gal J, Chignon-Sicard B (2012) Functional impairment and its impact on sporting activities after latissimus dorsi flap breast reconstruction. Ann Chir Plast Esthet 57(6):567–574CrossRefPubMed
19.
go back to reference Spear SL, Economides JM, Shuck J, Patel KM (2014) Analyzing implant movement with tabbed and nontabbed expanders through the process of two-stage breast reconstruction. Plast Reconstr Surg 133(3):256e–260eCrossRefPubMed Spear SL, Economides JM, Shuck J, Patel KM (2014) Analyzing implant movement with tabbed and nontabbed expanders through the process of two-stage breast reconstruction. Plast Reconstr Surg 133(3):256e–260eCrossRefPubMed
20.
go back to reference Reitsamer R, Peintinger F (2015) Prepectoral implant placement and complete coverage with porcine acellular dermal matrix: a new technique for direct-to-implant breast reconstruction after nipple-sparing mastectomy. J Plast Reconstr Aesthet Surg 68(2):162–167CrossRefPubMed Reitsamer R, Peintinger F (2015) Prepectoral implant placement and complete coverage with porcine acellular dermal matrix: a new technique for direct-to-implant breast reconstruction after nipple-sparing mastectomy. J Plast Reconstr Aesthet Surg 68(2):162–167CrossRefPubMed
22.
go back to reference Parker PA, Peterson SK, Bedrosian I et al: Prospective study of surgical decision-making processes for contralateral prophylactic mastectomy in women with breast cancer. Ann Surg 2015 Parker PA, Peterson SK, Bedrosian I et al: Prospective study of surgical decision-making processes for contralateral prophylactic mastectomy in women with breast cancer. Ann Surg 2015
23.
go back to reference Arving C, Sjoden PO, Bergh J et al (2007) Individual psychosocial support for breast cancer patients: a randomized study of nurse versus psychologist interventions and standard care. Cancer Nurs 30(3):E10–19CrossRefPubMed Arving C, Sjoden PO, Bergh J et al (2007) Individual psychosocial support for breast cancer patients: a randomized study of nurse versus psychologist interventions and standard care. Cancer Nurs 30(3):E10–19CrossRefPubMed
24.
go back to reference Remmers H, Holtgrawe M, Pinkert C (2010) Stress and nursing care needs of women with breast cancer during primary treatment: a qualitative study. Eur J Oncol Nurs 14(1):11–16CrossRefPubMed Remmers H, Holtgrawe M, Pinkert C (2010) Stress and nursing care needs of women with breast cancer during primary treatment: a qualitative study. Eur J Oncol Nurs 14(1):11–16CrossRefPubMed
25.
go back to reference Thomsen JB, Gunnarsson GL (2014) The evolving breast reconstruction: from latissimus dorsi musculocutaneous flap to a propeller thoracodorsal fasciocutaneous flap. Gland Surg 3(3):151–154 Thomsen JB, Gunnarsson GL (2014) The evolving breast reconstruction: from latissimus dorsi musculocutaneous flap to a propeller thoracodorsal fasciocutaneous flap. Gland Surg 3(3):151–154
26.
go back to reference Hamdi M, Van Landuyt K, Hijjawi JB, Roche N, Blondeel P, Monstrey S (2008) Surgical technique in pedicled thoracodorsal artery perforator flaps: a clinical experience with 99 patients. Plast Reconstr Surg 121(5):1632–1641CrossRefPubMed Hamdi M, Van Landuyt K, Hijjawi JB, Roche N, Blondeel P, Monstrey S (2008) Surgical technique in pedicled thoracodorsal artery perforator flaps: a clinical experience with 99 patients. Plast Reconstr Surg 121(5):1632–1641CrossRefPubMed
27.
go back to reference Vaughn CJ, Peled AW, Esserman LJ, Foster RD: Feasibility of performing total skin-sparing mastectomy in patients with prior circumareolar mastopexy or reduction mammoplasty incisions. Ann Plast Surg 2013 Vaughn CJ, Peled AW, Esserman LJ, Foster RD: Feasibility of performing total skin-sparing mastectomy in patients with prior circumareolar mastopexy or reduction mammoplasty incisions. Ann Plast Surg 2013
28.
go back to reference Alperovich M, Tanna N, Samra F et al (2013) Nipple-sparing mastectomy in patients with a history of reduction mammaplasty or mastopexy: how safe is it? Plast Reconstr Surg 131(5):962–967CrossRefPubMed Alperovich M, Tanna N, Samra F et al (2013) Nipple-sparing mastectomy in patients with a history of reduction mammaplasty or mastopexy: how safe is it? Plast Reconstr Surg 131(5):962–967CrossRefPubMed
29.
go back to reference Al-Mufarrej FM, Woods JE, Jacobson SR (2013) Simultaneous mastopexy in patients undergoing prophylactic nipple-sparing mastectomies and immediate reconstruction. J Plast Reconstr Aesthet Surg 66(6):747–755CrossRefPubMed Al-Mufarrej FM, Woods JE, Jacobson SR (2013) Simultaneous mastopexy in patients undergoing prophylactic nipple-sparing mastectomies and immediate reconstruction. J Plast Reconstr Aesthet Surg 66(6):747–755CrossRefPubMed
30.
go back to reference Beale EW, Ramanadham S, Harrison B, Rasko Y, Armijo B, Rohrich RJ (2014) Achieving predictability in augmentation mastopexy. Plast Reconstr Surg 133(3):284e–292eCrossRefPubMed Beale EW, Ramanadham S, Harrison B, Rasko Y, Armijo B, Rohrich RJ (2014) Achieving predictability in augmentation mastopexy. Plast Reconstr Surg 133(3):284e–292eCrossRefPubMed
31.
go back to reference Tuli R, Flynn RA, Brill KL, Sabol JL, Usuki KY, Rosenberg AL (2006) Diagnosis, treatment, and management of breast cancer in previously augmented women. Breast J 12(4):343–348CrossRefPubMed Tuli R, Flynn RA, Brill KL, Sabol JL, Usuki KY, Rosenberg AL (2006) Diagnosis, treatment, and management of breast cancer in previously augmented women. Breast J 12(4):343–348CrossRefPubMed
32.
go back to reference Clemens MW, Kronowitz SJ (2012) Acellular dermal matrix in irradiated tissue expander/implant–based breast reconstruction: evidence-based review. Plast Reconstr Surg 130(5S-2):27S–34SCrossRefPubMed Clemens MW, Kronowitz SJ (2012) Acellular dermal matrix in irradiated tissue expander/implant–based breast reconstruction: evidence-based review. Plast Reconstr Surg 130(5S-2):27S–34SCrossRefPubMed
33.
go back to reference Kim JYS, Davila AA, Persing S et al (2012) A meta-analysis of human acellular dermis and submuscular tissue expander breast reconstruction. Plast Reconstr Surg 129(1):28–41CrossRefPubMed Kim JYS, Davila AA, Persing S et al (2012) A meta-analysis of human acellular dermis and submuscular tissue expander breast reconstruction. Plast Reconstr Surg 129(1):28–41CrossRefPubMed
34.
go back to reference Clough K, Kaufman G, Nos C, Buccimazza I, Sarfati I (2010) Improving breast cancer surgery: a classification and quadrant per quadrant atlas for oncoplastic surgery. Ann Surg Oncol 17(5):1375–1391CrossRefPubMed Clough K, Kaufman G, Nos C, Buccimazza I, Sarfati I (2010) Improving breast cancer surgery: a classification and quadrant per quadrant atlas for oncoplastic surgery. Ann Surg Oncol 17(5):1375–1391CrossRefPubMed
35.
go back to reference Lee JW, Kim MC, Park HY, Yang JD (2014) Oncoplastic volume replacement techniques according to the excised volume and tumor location in small- to moderate-sized breasts. Gland Surg 3(1):14–21PubMedPubMedCentral Lee JW, Kim MC, Park HY, Yang JD (2014) Oncoplastic volume replacement techniques according to the excised volume and tumor location in small- to moderate-sized breasts. Gland Surg 3(1):14–21PubMedPubMedCentral
36.
go back to reference Nava MB, Ottolenghi J, Pennati A et al (2012) Skin/nipple sparing mastectomies and implant-based breast reconstruction in patients with large and ptotic breast: oncological and reconstructive results. Breast 21(3):267–271CrossRefPubMed Nava MB, Ottolenghi J, Pennati A et al (2012) Skin/nipple sparing mastectomies and implant-based breast reconstruction in patients with large and ptotic breast: oncological and reconstructive results. Breast 21(3):267–271CrossRefPubMed
38.
go back to reference Ho G, Nguyen TJ, Shahabi A, Hwang BH, Chan LS, Wong AK (2012) A systematic review and meta-analysis of complications associated with acellular dermal matrix-assisted breast reconstruction. Ann Plast Surg 68(4):346–356CrossRefPubMed Ho G, Nguyen TJ, Shahabi A, Hwang BH, Chan LS, Wong AK (2012) A systematic review and meta-analysis of complications associated with acellular dermal matrix-assisted breast reconstruction. Ann Plast Surg 68(4):346–356CrossRefPubMed
39.
go back to reference Park HC, Kim HY, Kim MC et al (2014) Partial breast reconstruction using various oncoplastic techniques for centrally located breast cancer. Arch Plast Surg 41(5):520–528CrossRefPubMedPubMedCentral Park HC, Kim HY, Kim MC et al (2014) Partial breast reconstruction using various oncoplastic techniques for centrally located breast cancer. Arch Plast Surg 41(5):520–528CrossRefPubMedPubMedCentral
40.
go back to reference Davies K, Allan L, Roblin P, Ross D, Farhadi J (2011) Factors affecting post-operative complications following skin sparing mastectomy with immediate breast reconstruction. Breast 20(1):21–25CrossRefPubMed Davies K, Allan L, Roblin P, Ross D, Farhadi J (2011) Factors affecting post-operative complications following skin sparing mastectomy with immediate breast reconstruction. Breast 20(1):21–25CrossRefPubMed
41.
go back to reference Delay E, Garson S, Tousson G, Sinna R (2009) Fat injection to the breast: technique, results, and indications based on 880 procedures over 10 years. Aesthet Surg J 29(5):360–376CrossRefPubMed Delay E, Garson S, Tousson G, Sinna R (2009) Fat injection to the breast: technique, results, and indications based on 880 procedures over 10 years. Aesthet Surg J 29(5):360–376CrossRefPubMed
42.
go back to reference Petit JY, Rietjens M, Botteri E et al (2013) Evaluation of fat grafting safety in patients with intraepithelial neoplasia: a matched-cohort study. Ann Oncol 24(6):1479–1484CrossRefPubMed Petit JY, Rietjens M, Botteri E et al (2013) Evaluation of fat grafting safety in patients with intraepithelial neoplasia: a matched-cohort study. Ann Oncol 24(6):1479–1484CrossRefPubMed
43.
go back to reference Hamdi M, Van Landuyt K, Tonnard P, Verpaele A, Monstrey S (2009) Septum-based mammaplasty: a surgical technique based on Wuringer’s septum for breast reduction. Plast Reconstr Surg 123(2):443–454CrossRefPubMed Hamdi M, Van Landuyt K, Tonnard P, Verpaele A, Monstrey S (2009) Septum-based mammaplasty: a surgical technique based on Wuringer’s septum for breast reduction. Plast Reconstr Surg 123(2):443–454CrossRefPubMed
44.
go back to reference Andrade RA, Coca KP, Abrao AC (2010) Breastfeeding pattern in the first month of life in women submitted to breast reduction and augmentation. J Pediatr (Rio J) 86(3):239–244CrossRef Andrade RA, Coca KP, Abrao AC (2010) Breastfeeding pattern in the first month of life in women submitted to breast reduction and augmentation. J Pediatr (Rio J) 86(3):239–244CrossRef
45.
go back to reference Thibaudeau S, Sinno H, Williams B (2010) The effects of breast reduction on successful breastfeeding: a systematic review. J Plast Reconstr Aesthet Surg 63(10):1688–1693CrossRefPubMed Thibaudeau S, Sinno H, Williams B (2010) The effects of breast reduction on successful breastfeeding: a systematic review. J Plast Reconstr Aesthet Surg 63(10):1688–1693CrossRefPubMed
46.
go back to reference Kakagia D, Tripsiannis G, Tsoutsos D (2005) Breastfeeding after reduction mammaplasty: a comparison of 3 techniques. Ann Plast Surg 55(4):343–345CrossRefPubMed Kakagia D, Tripsiannis G, Tsoutsos D (2005) Breastfeeding after reduction mammaplasty: a comparison of 3 techniques. Ann Plast Surg 55(4):343–345CrossRefPubMed
47.
go back to reference Leal SC, Stuart SR, Carvalho Hde A (2013) Breast irradiation and lactation: a review. Expert Rev Anticancer Ther 13(2):159–164CrossRefPubMed Leal SC, Stuart SR, Carvalho Hde A (2013) Breast irradiation and lactation: a review. Expert Rev Anticancer Ther 13(2):159–164CrossRefPubMed
Metadata
Title
Assessment and planning for oncoplastic and reconstructive breast surgery: a review and a proposed chart
Author
Amit Agrawal
Publication date
01-10-2016
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Plastic Surgery / Issue 5/2016
Print ISSN: 0930-343X
Electronic ISSN: 1435-0130
DOI
https://doi.org/10.1007/s00238-016-1221-7

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