Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

ACC 2024 Congress

Catch up on all the top stories and latest evidence in cardiology research with our ACC 2024 Congress hub page.
ADVANCED SEARCH
Log in
Top
Current Breast Cancer Reports
Published in: Current Breast Cancer Reports 2/2019

01-06-2019 | Breast Surgery | Local-Regional Evaluation and Therapy (DM Euhus, Section Editor)

Practical Perspectives Regarding Patient Selection and Technical Considerations in Oncoplastic Surgery

Authors: Abhishek Chatterjee, Mengdi Yao, Yurie Sekigami, Yuanxin Liang, Salvatore Nardello

Published in: Current Breast Cancer Reports | Issue 2/2019

Login to get access

Abstract

Purpose of Review

Oncoplastic surgery is a form of breast conservation surgery that involves volume displacement and replacement techniques to reconstruct the breast after a partial mastectomy. We aimed to report our clinical experiences with support from the literature as to the optimal application of oncoplastic surgery with regard to patient and disease selection and presentation, and discuss common technical considerations.

Recent Findings

Based on clinical experience and recent literature, oncoplastic surgery has several oncologic and reconstructive strengths including a decreased positive margin rate, high patient satisfaction, and additional benefit when applied to patients with both breast cancer and symptomatic macromastia.

Summary

Oncoplastic surgery constitutes an additional breast conservation option that is safe, well tolerated, and can provide autologous reconstruction after a large oncologic resection in a one-staged surgical effort that adds value for the appropriate breast cancer patient.
Literature
1.
Clough KB, Kaufman GJ, Nos C, Buccimazza I, Sarfati IM. Improving breast cancer surgery: a classification and quadrant per quadrant atlas for oncoplastic surgery. Ann Surg Oncol. 2010;17(5):1375–91.CrossRef
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.CrossRef
3.
Hu J, Rainsbury RM, Segaran A, Predescu O, Roy PG. Objective assessment of clinical, oncological and cosmetic outcomes following volume replacement in patients undergoing oncoplastic breast-conserving surgery: protocol for a systematic review. BMJ Open. 2018;8(7):e020859.CrossRef
4.
Losken A, Hart AM, Chatterjee A. Updated evidence on the oncoplastic approach to breast conservation therapy. Plast Reconstr Surg. 2017;140(5S Advances in Breast Reconstruction):14S–22S.CrossRef
5.
Rainsbury RM. Surgery insight: oncoplastic breast-conserving reconstruction—indications, benefits, choices and outcomes. Nat Rev Clin Oncol. 2007;4(11):657–64.CrossRef
6.
Chatterjee A, Gass J, Burke MB, Kopkash K, El-Tamer MB, Holmes DR, et al. Results from the American Society of Breast Surgeons Oncoplastic Surgery Committee 2017 survey: current practice and future directions. Ann Surg Oncol. 2018;25:2790–4.CrossRef
7.
Jonczyk MM, Jean J, Graham R, Chatterjee A. Surgical trends in breast cancer: a rise in novel operative treatment options over a 12 year analysis. Breast Cancer Res Treat. 2018;1–8.
8.
•• Cruz MLDL, Blankenship MSA, MPH, MS, Chatterjee MA, Geha MR, et al. Outcomes after oncoplastic breast-conserving surgery in breast cancer patients: a systematic literature review. 0(0):1–12. This review confirmed the oncologic safety of oncoplastic surgery in patients with T1-T2 disease by revealing high rates of overall survival and disease-free survival with low local recurrence, distant recurrence, positive margin rate, re-excision rate, conversion to mastectomy rate and complication rates.
9.
• Kelsall JE, McCulley SJ, Brock L, Akerlund MTE, Macmillan RD. Comparing oncoplastic breast conserving surgery with mastectomy and immediate breast reconstruction: case-matched patient reported outcomes. J Plast Reconstr Aesthet Surg. This paper compared outcomes between women undergoing oncoplastic breast conserving surgery and those undergoing mastectomy and immediate reconstruction with regards to body image scale scores of psychosocial function and patient reported outcome measures for breast appearance and return to function. Better psychosocial and self-rated satisfaction with breast appearance was achieved for oncoplastic breast conserving surgery.
10.
Chatterjee A. Long term effects of modern breast cancer surgery. Gland Surg. 2017.
11.
Barnea Y, Friedman O, Arad E, Barsuk D, Menes T, Zaretski A, et al. An oncoplastic breast augmentation technique for immediate partial breast reconstruction following breast conservation. Plast Reconstr Surg. 2017;139(2):348e–57e.CrossRef
12.
Almasad JK, Salah B. Breast reconstruction by local flaps after conserving surgery for breast cancer: an added asset to oncoplastic techniques. Breast J. 2008;14(4):340–4.CrossRef
13.
Chagpar AB, Killelea BK, Tsangaris TN, Butler M, Stavris K, Li F, et al. A randomized, controlled trial of cavity shave margins in breast cancer. N Engl J Med. 2015;373(6):503–10.CrossRef
14.
Weber WP, Soysal SD, El-Tamer M, Sacchini V, Knauer M, Tausch C, et al. First international consensus conference on standardization of oncoplastic breast conserving surgery. Breast Cancer Res Treat. 2017;165(1):139–49.CrossRef
15.
• Losken A, Dugal CS, Styblo TM, Carlson GW. A meta-analysis comparing breast conservation therapy alone to the oncoplastic technique. Ann Plast Surg. 2014;72(2):145–9. This paper compared literature outcomes between BCT alone and BCT with the oncoplastic approach and found lower positive margin rate, reexcision rate, and local recurrence rate in the oncoplastic group. Satisfaction with the aesthetic outcome was also significantly higher in the oncoplastic group. CrossRef
16.
Patel KM, Hannan CM, Gatti ME, Nahabedian MY. A head-to-head comparison of quality of life and aesthetic outcomes following immediate, staged-immediate, and delayed oncoplastic reduction mammaplasty [outcomes article]. Plast Reconstr Surg. 2011;127(6):2167–75.CrossRef
17.
Roughton MC, Shenaq D, Jaskowiak N, Park JE, Song DH. Optimizing delivery of breast conservation therapy: a multidisciplinary approach to oncoplastic surgery. Ann Plast Surg. 2012;69(3):250–5.CrossRef
18.
Rezai M, Knispel S, Kellersmann S, Lax H, Kimmig R, Kern P. Systematization of oncoplastic surgery: selection of surgical techniques and patient-reported outcome in a cohort of 1,035 patients. Ann Surg Oncol. 2015;22(11):3730–7.CrossRef
19.
Wang HT, Barone CM, Steigelman MB, Kahlenberg M, Rousseau D, Berger J, et al. Aesthetic outcomes in breast conservation therapy. Aesthet Surg J. 2008;28(2):165–70.CrossRef
20.
Taylor AJ, Tate D, Brandberg Y, Blomqvist L. Cost-effectiveness of reduction mammaplasty. Int J Technol Assess Health Care. 2004;20(3):269–73.CrossRef
21.
Tykkä E, Räsänen P, Tukiainen E, Asko-Seljavaara S, Heikkilä A, Sintonen H, et al. Cost-utility of breast reduction surgery-a prospective study. J Plast Reconstr Aesthet Surg. 2010;63(1):87–92.CrossRef
22.
De La Cruz L, Blankenship SA, Chatterjee A, Geha R, Nocera N, Czerniecki BJ, et al. Outcomes after oncoplastic breast-conserving surgery in breast cancer patients: a systematic literature review. Ann Surg Oncol. 2016;23(10):3247–58.CrossRef
23.
Chand ND, Browne V, Paramanathan N, Peiris LJ, Laws SA, Rainsbury RM. Patient-reported outcomes are better after oncoplastic breast conservation than after mastectomy and autologous reconstruction. Plast Reconstr Surg Glob Open. 2017;5(7):e1419.CrossRef
24.
•• Asban A, Homsy C, Chen L, Fisher C, Losken A, Chatterjee A. A cost-utility analysis comparing large volume displacement oncoplastic surgery to mastectomy with single stage implant reconstruction in the treatment of breast cancer. Breast. 2018;41:159–64. This paper investigated the cost-utility of large volume displacement oncoplastic surgery versus mastectomy with single stage implant reconstruction and found large volume displacement oncoplastic surgery to be cost-effective compared to mastectomy with single staged implant reconstruction. CrossRef
25.
Chatterjee A, Offodile AC II, Asban A, Minasian RA, Losken A, Graham R, et al. A cost-utility analysis comparing oncoplastic breast surgery to standard lumpectomy in large breasted women. Adv Breast Cancer Res. 2018;07(02):14.CrossRef
26.
Chatterjee A, Asban A, Chen L, Fisher C. Abstract 56. A cost-utility analysis comparing large volume displacement oncoplastic surgery to mastectomy with free flap reconstruction in the treatment of breast cancer. Plast Reconstr Surg Glob Open. 2017;5(2 Suppl).CrossRef
Metadata
Title
Practical Perspectives Regarding Patient Selection and Technical Considerations in Oncoplastic Surgery
Authors
Abhishek Chatterjee
Mengdi Yao
Yurie Sekigami
Yuanxin Liang
Salvatore Nardello
Publication date
01-06-2019
Publisher
Springer US
Published in
Current Breast Cancer Reports / Issue 2/2019
Print ISSN: 1943-4588
Electronic ISSN: 1943-4596
DOI
https://doi.org/10.1007/s12609-019-0305-3

Other articles of this Issue 2/2019

Current Breast Cancer Reports 2/2019 Go to the issue

Local-Regional Evaluation and Therapy (DM Euhus, Section Editor)

Role of Liquid Biopsy in Clinical Decision-Making for Breast Cancer

Correction

Correction to: Ablative Treatment of Breast Cancer; Are We There Yet?

Breast Cancer Imaging and Screening (N Sharma, Section Editor)

Management of B3 Lesions—Practical Issues

Breast Cancer Imaging and Screening (N Sharma, Section Editor)

Interval Cancers and Duty of Candour, a UK Perspective

Local-Regional Evaluation and Therapy (DM Euhus, Section Editor)

Ablative Treatment of Breast Cancer; Are We There Yet?

Local-Regional Evaluation and Therapy (DM Euhus, Section Editor)

Surgical Therapy for Women with Multiple Synchronous Ipsilateral Breast Cancer (MIBC): Current Evidence to Guide Clinical Practice
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits