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Published in: Annals of Surgical Oncology 10/2018

01-10-2018 | Breast Oncology

Basic Oncoplastic Surgery for Breast Conservation: Tips and Techniques

Authors: Katherine Kopkash, MD, Patricia Clark, MD

Published in: Annals of Surgical Oncology | Issue 10/2018

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Abstract

Background

The demand for oncoplastic breast surgery has increased significantly in recent years. However, these procedures are often not taught in standard training for breast surgeons, and a simple guide for surgeons to start performing basic oncoplastic breast surgery techniques is not available.

Methods

The basic concepts of oncoplastic breast surgery and the tools needed prior to starting these types of procedures are discussed, and the procedure, in a stepwise pattern, for the building blocks of oncoplastic techniques is outlined.

Results

The importance of oncoplastics from a quality of life and oncologic standpoint are described. Key concepts are defined and the decision on when it is necessary to consult reconstructive plastic surgery is delineated. The basic necessities for oncoplastic breast surgery, including patient photographs, important intraoperative tools, anatomic knowledge, and patient selection, are discussed. The building block procedures include aesthetic scar placement, parenchymal closure, deepithelialization, and donut therapeutic mastopexy, which are described in detail.

Conclusions

Oncoplastic breast surgery techniques and clinical reasoning build on one another, allowing a surgeon to move from level I to level II oncoplastic procedures. Even the most basic level I breast conservation oncoplastic skills can improve a patient’s cosmetic outcome and are easily learned by a general surgeon.
Literature
1.
go back to reference Audretsch W, Kolotas C, Rezai M. Oncoplastic surgery in breast conserving therapy and flap supported operability. In: Paper presented at the Annual Symposium on Breast Surgery and Body Contouring 1993; Santa Fe. Audretsch W, Kolotas C, Rezai M. Oncoplastic surgery in breast conserving therapy and flap supported operability. In: Paper presented at the Annual Symposium on Breast Surgery and Body Contouring 1993; Santa Fe.
2.
go back to reference Waljee JF, Hu ES, Ubel PA, Smith DM, Newman LA, Alderman AK. Effect of esthetic outcome after breast-conserving surgery on psychosocial functioning and quality of life. J Clin Oncol. 2008;26(20):3331–3337.CrossRefPubMed Waljee JF, Hu ES, Ubel PA, Smith DM, Newman LA, Alderman AK. Effect of esthetic outcome after breast-conserving surgery on psychosocial functioning and quality of life. J Clin Oncol. 2008;26(20):3331–3337.CrossRefPubMed
3.
go back to reference Clough KB, Lewis JS, Couturaud B, Fitoussi A, Nos C, Falcou MC. Oncoplastic techniques allow extensive resections for breast-conserving therapy of breast carcinomas. Ann Surg. 2003;237(1):26–34.CrossRefPubMedPubMedCentral Clough KB, Lewis JS, Couturaud B, Fitoussi A, Nos C, Falcou MC. Oncoplastic techniques allow extensive resections for breast-conserving therapy of breast carcinomas. Ann Surg. 2003;237(1):26–34.CrossRefPubMedPubMedCentral
4.
go back to reference Rietjens M, Urban CA, Rey PC, et al. Long-term oncological results of breast conservative treatment with oncoplastic surgery. Breast. 2007;16(4):387–395.CrossRefPubMed Rietjens M, Urban CA, Rey PC, et al. Long-term oncological results of breast conservative treatment with oncoplastic surgery. Breast. 2007;16(4):387–395.CrossRefPubMed
5.
6.
go back to reference 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):1375–1391.CrossRefPubMed 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):1375–1391.CrossRefPubMed
7.
go back to reference Mathes SJ, Nahai F. Classification of the vascular anatomy of muscles: experimental and clinical correlation. Plast Reconstr Surg. 1981;67(2):177–187.CrossRefPubMed Mathes SJ, Nahai F. Classification of the vascular anatomy of muscles: experimental and clinical correlation. Plast Reconstr Surg. 1981;67(2):177–187.CrossRefPubMed
8.
go back to reference DiBernardo BE, Adams LR, Krause J, Fiorillo MA, Gheradini G. Photographic Standards in Plastic Surgery. Plastic and Reconstructive Surgery. 1998;102(2):559–568.CrossRefPubMed DiBernardo BE, Adams LR, Krause J, Fiorillo MA, Gheradini G. Photographic Standards in Plastic Surgery. Plastic and Reconstructive Surgery. 1998;102(2):559–568.CrossRefPubMed
9.
go back to reference Dharmawan R, Nagalingam S, Tay L, Wong C, Tan B. The use of compression belt in the prevention of seroma formation post-breast cancer surgery: a randomized trial. In: Paper presented at the Milan Breast Cancer Conference 2013; Milan. Dharmawan R, Nagalingam S, Tay L, Wong C, Tan B. The use of compression belt in the prevention of seroma formation post-breast cancer surgery: a randomized trial. In: Paper presented at the Milan Breast Cancer Conference 2013; Milan.
10.
go back to reference van Deventer P, Graewe F. The Blood Supply of the Breast Revisited. Plastic and Reconstructive Surgery. 2016;137(5):1388–1397.CrossRefPubMed van Deventer P, Graewe F. The Blood Supply of the Breast Revisited. Plastic and Reconstructive Surgery. 2016;137(5):1388–1397.CrossRefPubMed
11.
go back to reference Farina MA, Newby BG, Alani HM. Innervation of the nipple-areola complex. Plast Reconstr Surg. 1980;66(4):497–501.CrossRefPubMed Farina MA, Newby BG, Alani HM. Innervation of the nipple-areola complex. Plast Reconstr Surg. 1980;66(4):497–501.CrossRefPubMed
12.
go back to reference Ovadia SA, Bishop E, Zoghbi Y, Gasgarth R, Kassira W, Thaller SR. Pedicle De-epithelialization in Reduction Mammoplasty: A Systematic Review of the Literature. Aesthetic Plast Surg. 2018;42(1):100–111.CrossRefPubMed Ovadia SA, Bishop E, Zoghbi Y, Gasgarth R, Kassira W, Thaller SR. Pedicle De-epithelialization in Reduction Mammoplasty: A Systematic Review of the Literature. Aesthetic Plast Surg. 2018;42(1):100–111.CrossRefPubMed
13.
go back to reference Fournier P. Deepithelialization in Breast Reduction. In: Shiffman MA (ed). Mastopexy and Breast Reduction. Berlin: Springer; 2009. Fournier P. Deepithelialization in Breast Reduction. In: Shiffman MA (ed). Mastopexy and Breast Reduction. Berlin: Springer; 2009.
14.
go back to reference Benelli L. A new periareolar mammaplasty: the “round block” technique. Aesthetic Plast Surg. 1990;14(2):93–100.CrossRefPubMed Benelli L. A new periareolar mammaplasty: the “round block” technique. Aesthetic Plast Surg. 1990;14(2):93–100.CrossRefPubMed
15.
go back to reference Hammond DC, Khuthaila DK, Kim J. The interlocking Gore-Tex suture for control of areolar diameter and shape. Plast Reconstr Surg. 2007;119(3):804–809.CrossRefPubMed Hammond DC, Khuthaila DK, Kim J. The interlocking Gore-Tex suture for control of areolar diameter and shape. Plast Reconstr Surg. 2007;119(3):804–809.CrossRefPubMed
Metadata
Title
Basic Oncoplastic Surgery for Breast Conservation: Tips and Techniques
Authors
Katherine Kopkash, MD
Patricia Clark, MD
Publication date
01-10-2018
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 10/2018
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-018-6604-5

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