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
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 7/2005

01-07-2005 | Original Article

Comparative Study of Surgical Margins in Oncoplastic Surgery and Quadrantectomy in Breast Cancer

Authors: Navneet Kaur, MD, Jean-Yves Petit, MD, Mario Rietjens, MD, Fausto Maffini, MD, Alberto Luini, MD, Giovanna Gatti, MD, Pier Carlo Rey, MD, Cicero Urban, MD, Francesca De Lorenzi, MD, PhD

Published in: Annals of Surgical Oncology | Issue 7/2005

Login to get access

Abstract

Background

Oncoplastic surgery for breast cancer is a novel concept that combines a plastic surgical procedure with breast-conserving treatment to improve the final cosmetic results. The aim of this study was to evaluate the oncological safety of oncoplastic procedures by studying the status of the surgical margins of the excised tumor specimen in comparison with standard quadrantectomies.

Methods

Thirty consecutive breast cancer patients undergoing oncoplastic surgery (group 1) and 30 patients undergoing standard quadrantectomy (group 2) were prospectively studied with regard to the stage of breast cancer, the surgical procedures performed, the volume of breast tissue excised, and the histopathology of the tumor specimen, with specific details on surgical margins.

Results

Patients who underwent oncoplastic surgery (group 1) were younger (mean age, 48.73 years) than patients who had a classic quadrantectomy (group 2; mean age, 55.76 years; P = .022). The mean volume of the excised specimen in group 1 was 200.18 cm3, compared with 117.55 cm3 in group 2 (P = .016). Surgical margins were negative in 25 cases out of 30 in group 1 and 17 out of 30 in group 2 (P = .05). The average length of the surgical margin was 8.5 mm in group 1 and 6.5 mm in group 2, but the difference was not statistically significant (P = .074).

Conclusions

Oncoplastic surgery adds to the oncological safety of breast-conserving treatment because a larger volume of breast tissue can be excised and a wider negative margin can be obtained. It is especially indicated for large tumors, for which standard breast-conserving treatment has a high probability of leaving positive margins.
Literature
1.
Jakesz, R, Samonigg, H, Gnant, M,  et al. 2003Significant increase in breast conservation in 16 years of trials conducted by the Austrian Breast and Colorectal Cancer Study GroupAnn Surg23755664CrossRefPubMed
2.
Fisher, B, Dignam, J, Wolmark, N,  et al. 1998Lumpectomy and radiation therapy for the treatment of intraductal breast cancer: findings from National Surgical Adjuvant Breast and Bowel ProjectJ Clin Oncol1644152PubMed
3.
Schwartz, GF, Birchansky, CA, Komarnicky, LT,  et al. 1994Induction chemotherapy followed by breast conservation for locally advanced carcinoma of the breastCancer733629
4.
Doridot, V, Nos, C, Aucouturier, JS, Sigal-Zafrani, B, Fourquet, A, Clough, KB 2004Breast-conserving therapy of breast cancerCancer Radiother8218PubMed
5.
Clough, KB, Lewis, JS, Couturand, B, Fitoussi, A, Nac, S, Falcou, MC 2003Oncoplastic techniques allow extensive resections for breast-conserving therapy of breast carcinomasAnn Surg2372634PubMed
6.
Audretsch, W, Rezai, M, Kolotas, C,  et al. 1998Tumor-specific immediate reconstruction in breast cancer patientsPerspect Plast Surg1171100
7.
Rainsbury, RM 2003Training and skills for breast surgeons in the new millenniumANZ J Surg735116PubMed
8.
Baildam, AD 2002Oncoplastic surgery of the breastBr J Surg895323PubMed
9.
10.
Noguchi, M, Saito, Y, Mizukami, Y,  et al. 1991Breast deformity, its correction and assessment of breast-conserving surgeryBreast Cancer Res Treat181118PubMed
11.
Raja, MAK, Straker, VF, Rainsbury, RM 1997Extending the role of breast-conserving surgery by immediate volume replacementBr J Surg841015CrossRefPubMed
12.
Rainsbury, RM, Paramanathan, N 1998Recent progress with breast conserving volume replacement using latissimus dorsi miniflaps in UK patientsBreast Cancer513947PubMed
13.
Dixon, JM, Venizelos, B, Chan, P 2002Latissimus dorsi miniflap: a new technique for extending breast conservationBreast115865PubMed
14.
Clough, KB, Kroll, SS, Audretsch, W 1999An approach to the repair of partial mastectomy defectsPlast Reconstr Surg10440920PubMed
15.
Nos, C, Fitoussi, A, Bourgeois, D, Fourquet, A, Salmon, RJ, Klough, KB 1998Conservative treatment of lower pole breast cancers by bilateral mammoplasty and radiotherapyEur J Surg Oncol2450814PubMed
16.
Petit, JY, Garusi, C, Greuse, M,  et al. 2002One hundred and eleven cases of breast conservation treatment with simultaneous reconstruction at the European Institute of Oncology (Milan)Tumori88417PubMed
17.
Silverstein, MJ, Lagios, MD, Groshen, S,  et al. 1999The influence of margin width on local control of ductal carcinoma in situ of the breastN Engl J Med340145561PubMed
18.
Veronesi, U, Volteranni, F, Luini, A,  et al. 1990Quadrantectomy versus lumpectomy for small size breast cancerEur J Cancer266713PubMed
19.
Schnitt, SJ, Abner, A, Gelman, R, Connelly, JL 1994The relationship between microscopic margins of resection and the risk of local recurrence in patients treated with breast conserving surgery and radiation therapyCancer74174651
20.
Meric, F, Mirza, NQ, Vlastos, G 2003Positive surgical margins and ipsilateral breast tumor recurrence predict disease-specific survival after breast conserving therapyCancer9792633
21.
Mokbel, K, Ahmed, M, Nash, A, Sacks, N 1995Re-excision operations in non palpable breast cancerJ Surg Oncol582258PubMed
22.
Clarke, K, Le, MG, Sarrazin, D,  et al. 1985Analysis of loco-regional relapses in patients with early breast cancer treated by excision and radiotherapy: experience of the Institute Gustave-RoussyInt J Radiat Oncol Biol Phys1113745PubMed
23.
Singletary, SE 2002Surgical margins in patients with early stage breast cancer treated with breast conservation therapyAm J Surg18438393CrossRefPubMed
24.
Graham, RA, Homer, MJ, Katz Judith, K, Rothschild, J, Safaii, H, Supram, S 2002The pancake phenomenon contributes to the inaccuracy of margin assessment in patients with breast cancerAm J Surg1848993PubMed
25.
Mustonen, P, Harma, M 2002Viewpoints on oncoplastic surgery in invasive breast cancerScand J Surg91255258–62PubMed
26.
Veronesi, U, Cascinelli, N, Mariani, L,  et al. 2003Twenty-year follow-up of a randomized study comparing breast conserving surgery with radical mastectomy for early breast cancerN Engl J Med347122732CrossRef
27.
Gerber, B, Krause, A, Reimer, T,  et al. 2003Skin-sparing mastectomy with conservation of the nipple-areola complex and autologous reconstruction is an oncologically safe procedureAnn Surg2381207PubMed
28.
Benelli, L 1990A new periareolar mammoplasty: round block techniqueAesthetic Plast Surg1499106CrossRef
29.
Galimberti, V, Zurrida, S, Zanini, V,  et al. 1993Central small size breast cancer: how to overcome the problem of nipple and areola involvement?Eur J Cancer2910936
30.
Raja, MAK, Straker, VE, Rainsbury, RM 1997Extending the role of breast-conserving surgery by immediate volume replacementBr J Surg841015CrossRefPubMed
31.
Asgeirsson, KS, McCulley, SJ, Pinder, SE, Macmillan, RD 2003Size of invasive breast cancer and risk of local recurrence after breast-conservation therapyEur J Cancer3924629
32.
Silverstein, MJ, Gierson, ED, Colburn, WJ,  et al. 1994Can intraductal breast carcinoma be excised completely by local excision? Clinical and pathologic predictorsCancer7329859
33.
Vicini, FA, Kestin, LL, Goldstein, NS,  et al. 2001Relationship between excision volume, margin status, and tumor size with the development of local recurrence in patients with ductal carcinoma in situ treated with breast conserving therapyJ Surg Oncol7624554PubMed
34.
Bonadonna, G, Veronesi, U, Brumbilla, C,  et al. 1990Primary chemotherapy to avoid mastectomy in tumors with diameters of three centimeters or moreJ Natl Cancer Inst82153945PubMed
35.
Rietjens, M, Petit, JY, Contesso, G 1997The role of reduction mammoplasty in oncologyEur J Plast Surg2024650CrossRef
36.
Gray, JR, McCormick, B, Cox, L, Yahalom, J 1991Primary breast irradiation in large-breasted or heavy women: analysis of cosmetic outcomeInt J Radiat Oncol Biol Phys2134754PubMed
37.
Moody, AM, Mayles, WP, Bliss, JM,  et al. 1994The influence of breast size on late radiation effects and association with radiotherapy dose inhomogeneityRadiother Oncol3310612PubMed
Metadata
Title
Comparative Study of Surgical Margins in Oncoplastic Surgery and Quadrantectomy in Breast Cancer
Authors
Navneet Kaur, MD
Jean-Yves Petit, MD
Mario Rietjens, MD
Fausto Maffini, MD
Alberto Luini, MD
Giovanna Gatti, MD
Pier Carlo Rey, MD
Cicero Urban, MD
Francesca De Lorenzi, MD, PhD
Publication date
01-07-2005
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 7/2005
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/ASO.2005.12.046

Other articles of this Issue 7/2005

Annals of Surgical Oncology 7/2005 Go to the issue

OriginalPaper

External Jugular Vein Cutdown Approach, as a Useful Alternative, Supports the Choice of the Cephalic Vein for Totally Implantable Access Device Placement

Original Articles

Pathologic Nipple Discharge: Surgery Is Imperative in Postmenopausal Women

OriginalPaper

Primary Hyperparathyroidism: Can Parathyroid Carcinoma Be Anticipated on Clinical and Biochemical Grounds? Report of Nine Cases and Review of the Literature

OriginalPaper

A Tat Fusion Protein–Based Tumor Vaccine for Breast Cancer

Editorial

Predicting the Presence of Parathyroid Carcinoma

OriginalPaper

Fusion Image of Positron Emission Tomography and Computed Tomography for the Diagnosis of Local Recurrence of Rectal Cancer