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Erschienen in: Breast Cancer 3/2016

14.01.2015 | Original Article

The effectiveness of simultaneous oncoplastic breast surgery in patients with locally advanced breast cancer

verfasst von: Mustafa Emiroglu, Ismail Sert, Cem Karaali, Süleyman Ozkan Aksoy, Levent Ugurlu, Cengiz Aydın

Erschienen in: Breast Cancer | Ausgabe 3/2016

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Abstract

Background

Oncological outcomes of the oncoplastic breast surgery in patients with locally advanced breast cancer (LABC) are not well defined. This study examined the effects of oncoplastic techniques for LABC in terms of localized control and survival. We also evaluated the esthetic results of patients who had undergone oncoplastic breast conservation surgery (OBCS) and their satisfaction with the outcome.

Methods

The files and Medula (Probel Co.) database records of the patients were studied retrospectively. The esthetic evaluation was conducted by a panel. A validated satisfaction study was also performed.

Results

In total, 42 LABC cases (median age 48 years; range 33–69 years) were included. The median observation period was 61 months (range 26–151 months). Neoadjuvant chemotherapy (NACT) was administered in 32 (76 %) cases, and a pathologic complete response was observed in 7 (16.7 %) cases. The median T size during the post-NACT pathological study was 27 mm (range 0–44 mm). Oncoplastic reduction surgery was performed in 13 cases, a glandular flap in 7, Grisotti flap in 5, and latissimus dorsi flap in 3 cases. The median specimen weight was 198 g (range 103–812 g), and the mean surgical margin length was 8.7 mm (range 5–17 mm). The margin was positive in 7.1 % of cases, and the local repetition rate was 14.6 %. The total survival rate was 86.6 %, and disease-free survival was 59.6 %. The rate of excellent and good ratings by the esthetic assessment panel was 79.4 %. The satisfaction rate was 88.2 %. The early and delayed complication rate was 16.7 %.

Conclusions

Oncoplastic techniques are suitable and safe for patients undergoing OBCS. These techniques do not pose a risk to oncological local control. No survival or follow-up problems were detected during the 5-year follow-up period, the esthetic results were acceptable, and the satisfaction rate was high.
Literatur
1.
Zurück zum Zitat Ozmen V, Unal ES, Muslumanoglu ME, Igci A, Canbay E, Ozcinar B, et al. Axillary sentinel node biopsy after neoadjuvant chemotherapy. Eur J Surg Oncol. 2010;36(1):23–9.CrossRefPubMed Ozmen V, Unal ES, Muslumanoglu ME, Igci A, Canbay E, Ozcinar B, et al. Axillary sentinel node biopsy after neoadjuvant chemotherapy. Eur J Surg Oncol. 2010;36(1):23–9.CrossRefPubMed
2.
Zurück zum Zitat Thomssen C, Harbeck N. ABC2 consensus conference on advanced breast cancer: brief summary of the consensus panel on Saturday November 9, 2013. Breast Care (Basel). 2013;8(6):455–6.CrossRef Thomssen C, Harbeck N. ABC2 consensus conference on advanced breast cancer: brief summary of the consensus panel on Saturday November 9, 2013. Breast Care (Basel). 2013;8(6):455–6.CrossRef
3.
Zurück zum Zitat Fisher B, Brown A, Mamounas E, Wieand S, Robidoux A, Margolese RG, et al. Effect of preoperative chemotherapy on local-regional disease in women with operable breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-18. J Clin Oncol. 1997;15(7):2483–93.PubMed Fisher B, Brown A, Mamounas E, Wieand S, Robidoux A, Margolese RG, et al. Effect of preoperative chemotherapy on local-regional disease in women with operable breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-18. J Clin Oncol. 1997;15(7):2483–93.PubMed
4.
Zurück zum Zitat van der Hage JA, van de Velde CJ, Julien JP, Tubiana-Hulin M, Vandervelden C, Duchateau L. Preoperative chemotherapy in primary operable breast cancer: results from the European Organization for Research and Treatment of Cancer trial 10902. J Clin Oncol. 2001;19(22):4224–37.PubMed van der Hage JA, van de Velde CJ, Julien JP, Tubiana-Hulin M, Vandervelden C, Duchateau L. Preoperative chemotherapy in primary operable breast cancer: results from the European Organization for Research and Treatment of Cancer trial 10902. J Clin Oncol. 2001;19(22):4224–37.PubMed
5.
Zurück zum Zitat Gianni L, Baselga J, Eiermann W, Porta VG, Semiglazov V, Lluch A. Phase III trial evaluating the addition of paclitaxel to doxorubicin followed by cyclophosphamide, methotrexate, and fluorouracil, as adjuvant or primary systemic therapy: European Cooperative Trial in Operable Breast Cancer. J Clin Oncol. 2009;27(15):2474–81. doi:10.1200/JCO.2008.19.2567.CrossRefPubMed Gianni L, Baselga J, Eiermann W, Porta VG, Semiglazov V, Lluch A. Phase III trial evaluating the addition of paclitaxel to doxorubicin followed by cyclophosphamide, methotrexate, and fluorouracil, as adjuvant or primary systemic therapy: European Cooperative Trial in Operable Breast Cancer. J Clin Oncol. 2009;27(15):2474–81. doi:10.​1200/​JCO.​2008.​19.​2567.CrossRefPubMed
6.
Zurück zum Zitat Wilkins EG, Cederna PS, Lowery JC, Davis JA, Kim HM, Roth RS. Prospective analysis of psychosocial outcomes in breast reconstruction: one-year postoperative results from the Michigan Breast Reconstruction Outcome Study. Plast Reconstr Surg. 2000;106(5):1014–25 discussion 1026-7.CrossRefPubMed Wilkins EG, Cederna PS, Lowery JC, Davis JA, Kim HM, Roth RS. Prospective analysis of psychosocial outcomes in breast reconstruction: one-year postoperative results from the Michigan Breast Reconstruction Outcome Study. Plast Reconstr Surg. 2000;106(5):1014–25 discussion 1026-7.CrossRefPubMed
7.
Zurück zum Zitat Tewari M, Krishnamurthy A, Shukla HS. Breast conservation in locally advanced breast cancer in developing countries: wise or waste. Surg Oncol. 2009;18(1):3–13.CrossRefPubMed Tewari M, Krishnamurthy A, Shukla HS. Breast conservation in locally advanced breast cancer in developing countries: wise or waste. Surg Oncol. 2009;18(1):3–13.CrossRefPubMed
8.
Zurück zum Zitat Buchholz TA, Kronowitz SJ, Kuerer HM. Immediate breast reconstruction after skin-sparing mastectomy for the treatment of advanced breast cancer: radiation oncology considerations. Ann Surg Oncol. 2002;9(8):820–1.CrossRefPubMed Buchholz TA, Kronowitz SJ, Kuerer HM. Immediate breast reconstruction after skin-sparing mastectomy for the treatment of advanced breast cancer: radiation oncology considerations. Ann Surg Oncol. 2002;9(8):820–1.CrossRefPubMed
9.
Zurück zum Zitat Yang JD, Lee JW, Cho YK, Kim WW, Hwang SO, Jung JH, et al. Surgical techniques for personalized oncoplastic surgery in breast cancer patients with small- to moderate-sized breasts (part 2): volume replacement. J Breast Cancer. 2012;15(1):7–14.CrossRefPubMedPubMedCentral Yang JD, Lee JW, Cho YK, Kim WW, Hwang SO, Jung JH, et al. Surgical techniques for personalized oncoplastic surgery in breast cancer patients with small- to moderate-sized breasts (part 2): volume replacement. J Breast Cancer. 2012;15(1):7–14.CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Gulcelik MA, Dogan L, Yuksel M, Camlibel M, Ozaslan C, Reis E. Comparison of outcomes of standard and oncoplastic breast-conserving surgery. J Breast Cancer. 2013;16(2):193–7.CrossRefPubMedPubMedCentral Gulcelik MA, Dogan L, Yuksel M, Camlibel M, Ozaslan C, Reis E. Comparison of outcomes of standard and oncoplastic breast-conserving surgery. J Breast Cancer. 2013;16(2):193–7.CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Chevray PM. Timing of breast reconstruction: immediate versus delayed. Cancer J. 2008;14(4):223–9.CrossRefPubMed Chevray PM. Timing of breast reconstruction: immediate versus delayed. Cancer J. 2008;14(4):223–9.CrossRefPubMed
12.
Zurück zum Zitat 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. Plast Reconstr Surg. 2011;127(6):2167–75.CrossRefPubMed 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. Plast Reconstr Surg. 2011;127(6):2167–75.CrossRefPubMed
13.
Zurück zum Zitat Zucca Matthes AG, Uemura G, Kerr L, Matthes ÂC, Michelli RA, Folgueira MA, et al. Feasibility of oncoplastic techniques in the surgical management of locally advanced breast cancer. Int J Surg. 2012;10(9):500–5.CrossRefPubMed Zucca Matthes AG, Uemura G, Kerr L, Matthes ÂC, Michelli RA, Folgueira MA, et al. Feasibility of oncoplastic techniques in the surgical management of locally advanced breast cancer. Int J Surg. 2012;10(9):500–5.CrossRefPubMed
14.
Zurück zum Zitat Bogusevicius A, Cepuliene D, Sepetauskiene E. The integrated evaluation of the results of oncoplastic surgery for locally advanced breast cancer. Breast J. 2014;20(1):53–60.CrossRefPubMed Bogusevicius A, Cepuliene D, Sepetauskiene E. The integrated evaluation of the results of oncoplastic surgery for locally advanced breast cancer. Breast J. 2014;20(1):53–60.CrossRefPubMed
15.
Zurück zum Zitat Ozmen V. Breast cancer in Turkey. Turkiye klinikleri j Gen Surg-Spec Top. 2013;6(2):1–6. Ozmen V. Breast cancer in Turkey. Turkiye klinikleri j Gen Surg-Spec Top. 2013;6(2):1–6.
16.
Zurück zum Zitat Kataoka A, Tokunaga E, Masuda N, Shien T, Kawabata K, Miyashita M. Clinicopathological features of young patients (<35 years of age) with breast cancer in a Japanese Breast Cancer Society supported study. Breast Cancer. 2014;21(6):643–50.CrossRef Kataoka A, Tokunaga E, Masuda N, Shien T, Kawabata K, Miyashita M. Clinicopathological features of young patients (<35 years of age) with breast cancer in a Japanese Breast Cancer Society supported study. Breast Cancer. 2014;21(6):643–50.CrossRef
17.
Zurück zum Zitat Kayar R, Civelek S, Cobanoglu M, Gungor O, Catal H, Emiroglu M. Five methods of breast volume measurement: a comparative study of measurements of specimen volume in 30 mastectomy cases. Breast Cancer (Auckl). 2011;27(5):43–52. Kayar R, Civelek S, Cobanoglu M, Gungor O, Catal H, Emiroglu M. Five methods of breast volume measurement: a comparative study of measurements of specimen volume in 30 mastectomy cases. Breast Cancer (Auckl). 2011;27(5):43–52.
18.
Zurück zum Zitat Clough KB, Lewis JS, Couturaud B, Fitoussi A, Nos C, Falcau MC. Oncoplastic techniques allow extensive resections for breast-conserving therapy of breast carcinomas. Ann Surg. 2003;1:26–34.CrossRef Clough KB, Lewis JS, Couturaud B, Fitoussi A, Nos C, Falcau MC. Oncoplastic techniques allow extensive resections for breast-conserving therapy of breast carcinomas. Ann Surg. 2003;1:26–34.CrossRef
19.
Zurück zum Zitat Mazouni C, Naveau A, Kane A, Dunant A, Garbay JR, Leymarie N. The role of oncoplastic breast surgery in the management of breast cancer treated with primary chemotherapy. Breast. 2013;22(6):1189–93.CrossRefPubMed Mazouni C, Naveau A, Kane A, Dunant A, Garbay JR, Leymarie N. The role of oncoplastic breast surgery in the management of breast cancer treated with primary chemotherapy. Breast. 2013;22(6):1189–93.CrossRefPubMed
20.
Zurück zum Zitat Touboul E, Buffat L, Lefranc JP, Blondon J, Deniaud E, Mammar H, et al. Possibility of conservative local treatment after combined chemotherapy and preoperative irradiation for locally advanced noninflammatory breast cancer. Int J Radiat Oncol Biol Phys. 1996;34(5):1019–28.CrossRefPubMed Touboul E, Buffat L, Lefranc JP, Blondon J, Deniaud E, Mammar H, et al. Possibility of conservative local treatment after combined chemotherapy and preoperative irradiation for locally advanced noninflammatory breast cancer. Int J Radiat Oncol Biol Phys. 1996;34(5):1019–28.CrossRefPubMed
21.
Zurück zum Zitat Chen AM, Meric-Bernstam F, Hunt KK, Thomas HD, Outlaw ED, Strom EA, et al. Breast conservation treatment after neoadjuvant chemotherapy in locally advanced breast cancer: the M.D. Anderson Cancer Centre experience. JCO. 2004;22:2203–312.CrossRef Chen AM, Meric-Bernstam F, Hunt KK, Thomas HD, Outlaw ED, Strom EA, et al. Breast conservation treatment after neoadjuvant chemotherapy in locally advanced breast cancer: the M.D. Anderson Cancer Centre experience. JCO. 2004;22:2203–312.CrossRef
22.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
23.
Zurück zum Zitat Chakravorty A, Shrestha AK, Sanmugalingam N, Rapisarda F, Roche N, Querci Della Rovere G. How safe is oncoplastic breast conservation? Comparative analysis with standard breast conserving surgery. Eur J Surg Oncol. 2012;38(5):395–8. doi:10.1016/j.ejso.2012.02.186.CrossRefPubMed Chakravorty A, Shrestha AK, Sanmugalingam N, Rapisarda F, Roche N, Querci Della Rovere G. How safe is oncoplastic breast conservation? Comparative analysis with standard breast conserving surgery. Eur J Surg Oncol. 2012;38(5):395–8. doi:10.​1016/​j.​ejso.​2012.​02.​186.CrossRefPubMed
24.
Zurück zum Zitat Wolmarkt N, Wang J, Mamounas E, Bryant J, Fisher B. Preoperative chemotherapy in patients with operable breast cancer: nine-year results from National surgical adjuvant breast and bowel project B-18. J Natl Cancer Inst Monogr. 2001;30:96–102.CrossRef Wolmarkt N, Wang J, Mamounas E, Bryant J, Fisher B. Preoperative chemotherapy in patients with operable breast cancer: nine-year results from National surgical adjuvant breast and bowel project B-18. J Natl Cancer Inst Monogr. 2001;30:96–102.CrossRef
25.
Zurück zum Zitat Schwartz GF, Birchansky CA, Komarnicky LT, Mansfield CM, Cantor RI, Biermann WA, et al. Induction chemotherapy followed by breast conservation for locally advanced carcinoma of the breast. Cancer. 1994;73(2):362–9.CrossRefPubMed Schwartz GF, Birchansky CA, Komarnicky LT, Mansfield CM, Cantor RI, Biermann WA, et al. Induction chemotherapy followed by breast conservation for locally advanced carcinoma of the breast. Cancer. 1994;73(2):362–9.CrossRefPubMed
26.
Zurück zum Zitat Fitoussi AD, Berry MG, Famà F, Falcou MC, Curnier A, Couturaud B. Oncoplastic breast surgery for cancer: analysis of 540 consecutive cases [outcomes article]. Plast Reconstr Surg. 2010;125(2):454–62.CrossRefPubMed Fitoussi AD, Berry MG, Famà F, Falcou MC, Curnier A, Couturaud B. Oncoplastic breast surgery for cancer: analysis of 540 consecutive cases [outcomes article]. Plast Reconstr Surg. 2010;125(2):454–62.CrossRefPubMed
27.
Zurück zum Zitat Kronowitz SJ, Hunt KK, Kuerer HM, Strom EA, Buchholz TA, Ensor JE, et al. Practical guidelines for repair of partial mastectomy defects using the breast reduction technique in patients undergoing breast conservation therapy. Plast Reconstr Surg. 2007;120:1755–68.CrossRefPubMed Kronowitz SJ, Hunt KK, Kuerer HM, Strom EA, Buchholz TA, Ensor JE, et al. Practical guidelines for repair of partial mastectomy defects using the breast reduction technique in patients undergoing breast conservation therapy. Plast Reconstr Surg. 2007;120:1755–68.CrossRefPubMed
28.
Zurück zum Zitat Dogan L, Gulcelik MA, Karaman N, Ozaslan C, Reis E. Oncoplastic surgery in surgical treatment of breast cancer: is the timing of adjuvant treatment affected? Clin Breast Cancer. 2013;13(3):202–5.CrossRefPubMed Dogan L, Gulcelik MA, Karaman N, Ozaslan C, Reis E. Oncoplastic surgery in surgical treatment of breast cancer: is the timing of adjuvant treatment affected? Clin Breast Cancer. 2013;13(3):202–5.CrossRefPubMed
29.
Zurück zum Zitat Murthy V, Chamberlain RS. Nipple-sparing mastectomy in modern breast practice. Clin Anat. 2013;26(1):56–65.CrossRefPubMed Murthy V, Chamberlain RS. Nipple-sparing mastectomy in modern breast practice. Clin Anat. 2013;26(1):56–65.CrossRefPubMed
30.
Zurück zum Zitat Atiyeh B, Dibo S, Zgheib E, Abbas J. Skin sparing/skin reducing mastectomy (SSM/SRM) and the concept of oncoplastic breast surgery. Int J Surg. 2014;12(10):1115–22.CrossRefPubMed Atiyeh B, Dibo S, Zgheib E, Abbas J. Skin sparing/skin reducing mastectomy (SSM/SRM) and the concept of oncoplastic breast surgery. Int J Surg. 2014;12(10):1115–22.CrossRefPubMed
31.
Zurück zum Zitat Chirappapha P, Petit JY, Rietjens M, De Lorenzi F, Garusi C, Martella S, et al. Nipple sparing mastectomy: does breast morphological factor related to necrotic complications? Plast Reconstr Surg Glob Open. 2014;2(1):e99.CrossRefPubMedPubMedCentral Chirappapha P, Petit JY, Rietjens M, De Lorenzi F, Garusi C, Martella S, et al. Nipple sparing mastectomy: does breast morphological factor related to necrotic complications? Plast Reconstr Surg Glob Open. 2014;2(1):e99.CrossRefPubMedPubMedCentral
Metadaten
Titel
The effectiveness of simultaneous oncoplastic breast surgery in patients with locally advanced breast cancer
verfasst von
Mustafa Emiroglu
Ismail Sert
Cem Karaali
Süleyman Ozkan Aksoy
Levent Ugurlu
Cengiz Aydın
Publikationsdatum
14.01.2015
Verlag
Springer Japan
Erschienen in
Breast Cancer / Ausgabe 3/2016
Print ISSN: 1340-6868
Elektronische ISSN: 1880-4233
DOI
https://doi.org/10.1007/s12282-015-0585-z

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