Clinical scienceOutcome of oncoplastic breast surgery in 90 prospective patients
Section snippets
Patients and Methods
Oncoplastic techniques have been occasionally used in our unit for several years, but a specific project to increase and enhance the use of oncoplastic breast surgery was begun in 2005. Referrals and mammograms were screened to evaluate the feasibility of patients for an oncoplastic operation rather than conventional surgery. A substantial proportion of patients in the present study had tumors with large ductal carcinoma in situ (DCIS) or an extensive intraductal component or had a large tumor
Results
From January 2005 to December 2007 a total of 90 patients underwent an oncoplastic breast operation, reduction mammaplasty being the most commonly used surgical technique (Table 1; Figs. 1 and 2). Two patients had bilateral cancer treated with bilateral reduction mammaplasty. Fifty-nine of the remaining 88 patients had a contralateral reduction mammaplasty simultaneously with the tumor breast operation.
Seven patients had DCIS while the rest had invasive breast cancer (Table 2). Pathological
Comments
Oncoplastic breast surgery provides techniques to achieve good esthetic results and symmetry while also providing possibility for wide excision margins. However, 16.2% of our patients who underwent breast-conserving surgery still had an inadequate surgical margin and required a completion mastectomy. In our experience, this figure corresponds to the reoperation rate due to inadequate margins in conventional breast-conserving surgery. All of the patients with margin involvement had either
Conclusions
In conclusion, oncoplastic breast surgery offers tools for breast conservation in patients otherwise destined for mastectomy or poor esthetic outcome. Despite the high proportion of patients in this series with large-volume DCIS or extensive intraductal component, the use of oncoplastic techniques achieved negative margins with acceptable cosmetic results in the majority (84%) of patients.
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