Therapeutic Mammoplasty: Is it a Solution for Treatment of Early Breast Cancer?

Document Type : Original Article

Authors

1 The Departments of General Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt

2 The Departments of Plastic & Reconstructive Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt

Abstract

Conservative breast surgery has become the standard
treatment of early stages breast cancer as it provides the same
oncological safety as the classic mastectomy, but in many
cases, this led to marked breast deformity especially when
the resected mass is large or the mass is located in difficult
areas as the upper inner breast quadrant.
Objective: This study aims to evaluate the oncological
and aesthetic outcome of the therapeutic mammoplasty in
treating breast cancers located in the upper breast quadrants.
Patients and Methods: Oncoplastic excision of breast
cancer by doing bilateral inferior pedicle mammoplasty was
performed on 50 patients in Assiut University Hospital between
2016 and 2020. This study was performed on patients with
early-stage breast cancer located in the upper inner or outer
breast quadrants including those who received neoadjuvant
chemotherapy. Evaluation of the short-term surgical outcomes
including hospital stay, complications, and symmetrization
was done. Patient satisfaction and recurrence were also
assessed.
Results: A total of 50 patients were included in the study.
The mean age was 48.7 years and the tumors were located in
the upper outer quadrant, upper inner quadrant, and upper
breast pole in 35, 8, and 7 patients respectively. The mean
operative time was 3.2 hours. Only 12% of patients showed
early complications in form of seroma and wound dehiscence.
90% of the patients showed good symmetry and only 10%
showed fair symmetry in the last follow-up (18 months postoperative).
94% of our patients were highly satisfied with the
aesthetic outcome. We didn’t report any recurrence.
Conclusion: This study shows that oncoplastic breast
surgery, as the therapeutic mammoplasty, for breast cancers
in the upper breast quadrants can achieve equivalent oncological
results as the classic breast conservative surgery with
advantageous cosmetic outcome and breasts symmetry especially
the inferior pedicle mammoplasty technique which led
to much better patients’ satisfaction than the conventional
conservative surgeries.

Keywords

References

Campbell E.J. and Romics L.: Oncological safety and
cosmetic outcomes in oncoplastic breast conservation
surgery, a review of the best level of evidence literature.
Breast Cancer: Targets and Therapy, 9: 521, 2017.
2- Bohon C.: Cancer recognition and screening for common
breast disorders and malignancy. Obstet. Gynecol. Clin.,
44: 257-270, 2017.
3- Ahmed A.R.: HER2 expression is a strong independent
predictor of nodal metastasis in breast cancer. J. Egypt
Natl. Cancer Institute, 28: 219-227, 2016.
4- Kaufman C.S.: Increasing Role of Oncoplastic Surgery
for Breast Cancer. Curr. Oncol. Rep., 21 (12): 111. Published
2019 Dec 14. doi:10.1007/s11912-019-0860-9,
2019.
5- Silverstein M.J., Lagios M.D., Recht A., et al.: Imagedetected
breast cancer: State of the art diagnosis and
treatment. Journal of the American College of Surgeons,
Oct. 1; 201 (4): 586-97, 2005.
6- Douvetzemis S.E. and Kovacs T.: Concept, Principles and
Indication of Oncoplastic Breast Surgery: Fashion or
Necessity. In Oncoplastic Breast Surgery Techniques for
the General Surgeon (pp. 1-33). Springer, Cham., 2020.
7- Shaikh K., Krishnan S. and Thanki R.: Artificial Intelligence
in Breast Cancer Early Detection and Diagnosis.
Springer International Publishing AG, Dec 4, 2020.
8- Piper M., Peled A.W. and Sbitany H.: Oncoplastic breast
surgery: Current strategies. Gland Surg., 4: 154, 2015.
9- McIntosh J. and O'Donoghue J.M.: Therapeutic mammaplasty–
a systematic review of the evidence. European
Journal of Surgical Oncology (EJSO), Mar 1; 38 (3): 196-
202, 2012.
10- Eichlier C., Kolsch M., Sauerwald A., Bach A., Gluz O.
and Warm M.: Lumpectomy versus mastopexy? a postsurgery
patient survey. Anticancer Res., 33: 731-736,
2013.
11- Najafi M., Salmon R. and Kaviani A.: Oncological outcome
of oncoplastic breast surgery: A review of the literature.
Archives of Breast Cancer, Feb. 28: 5-14, 2015.
12- Emiroglu M., Karaali C., Salimoglu S., Sert I. and Aydın
C.: Oncoplastic reduction mammoplasty for breast cancer
in women with macromastia: Long term aesthetic, functional
and satisfaction outcomes. Contemp. Oncol., 20:
256, 2016.
13- Dixon J.M., editor. Breast Surgery: Companion to Specialist
Surgical Practice. Elsevier Health Sciences, Jun 22, 2013.
14- Jeevan R., Cromwell D.A., Trivella M., et al.: Reoperation
rates after breast conserving surgery for breast cancer
among women in England: Retrospective study of hospital
episode statistics. BMJ, Jul 12; 345, 2012.
15- Rose M., Manjer J., Ringberg A. and Henry Svensson:
Surgical strategy, methods of reconstruction, surgical
margins and postoperative complications in oncoplastic
breast surgery. Eur. J. Plast. Surg., 37: 205-214, 2014.
16- Tenofsky P.L., Dowell P., Topalovski T. and Helmer S.D.:
Surgical, oncologic, and cosmetic differences between
oncoplastic and nononcoplastic breast conserving surgery
in breast cancer patients. Am. J. Surg., 207: 398-402,
2014.
17- Chen D.R.: An optimized technique for all quadrant
oncoplasty in women with small-to medium-sized breasts.
Eur. Rev. Med. Pharmacol. Sci., 18: 1748-1754, 2014.
18- Ogawa T.: Usefulness of breast-conserving surgery using
the round block technique or modified round block technique
in Japanese females. Asian J. Surg., 37: 8-14, 2014.
19- Losken A., Dugal C.S., Styblo T.M. and Carlson G.W.:
A meta-analysis comparing breast conservation therapy
alone to the oncoplastic technique. Annals of Plastic
Surgery, Feb 1; 72 (2): 145-9, 2014.
20- Munhoz A.M., Aldrighi C.M., Montag E., et al.: Outcome
analysis of immediate and delayed conservative breast
surgery reconstruction with mastopexy and reduction
mammaplasty techniques. Annals of Plastic Surgery, Sep.
1; 67 (3): 220-5, 2011.
210 Vol. 45, No. 4 / Therapeutic Mammoplasty
21- Zaha H., Onomura M. and Unesoko M.: A new scarless
oncoplastic breastconserving surgery: Modified round
block technique. Breast, 22: 1184-1188, 2013.
22- Denewer A., Shahatto F., Elnahas W., Farouk O., Roshdy
S. and Khater A.: Therapeutic reduction mammoplasty
in large-breasted women with cancer using superior and
superomedial pedicles. Breast Cancer, 4: 167, 2012.
23- Bogusevicius A., Cepuliene D. and Sepetauskiene E.: The
integrated evaluation of the results of oncoplastic surgery
for locally advanced breast cancer. The Breast Journal,
Jan. 20 (1): 53-60, 2014.
24- Niinikoski L., Leidenius M.H., Vaara P., Voynov A.,
Heikkilä P. and Mattson J.: Resection margins and local
recurrences in breast cancer: Comparison between conventional
and oncoplastic breast conserving surgery. Eur.
J. Surg. Oncol., 45: 976-982, 2019.
25- Romics L., Macaskill E.J., Fernandez T., Simpson L.,
Morrow E. and Pitsinis V.: A population-based audit of
surgical practice and outcomes of oncoplastic breast
conservations in Scotland - an analysis of 589 patients.
Eur. J. Surg. Oncol., 44: 939-944, 2018.
26- Clough K.B., van la Parra R.F., Thygesen H.H., Levy E.,
Russ E. and Halabi N.M.: Long-term results after oncoplastic
surgery for breast cancer: A 10-year follow-up.
Ann. Surg., 268: 165-171, 2018.

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