Advertisement

Therapeutic breast reduction—are doctors and patients satisfied?

  • Carolina Andresen
  • Augusta Cardoso
  • Cristina Cunha
  • João Morais
  • Gustavo Coelho
  • Maria da Luz Barroso
  • João Guimarães
  • Horácio Costa
Original Paper
  • 7 Downloads

Abstract

Background

Therapeutic breast reduction (TBR) is an oncoplastic technique that applies breast reduction principles for oncologic purposes. Given that TBR indications have expanded, the purpose of this study is to ascertain the aesthetic outcome of this procedure, and determine how it may be influenced by different surgical techniques and postoperative radiotherapy.

Methods

A non-randomized cohort study was performed, including breast cancer female patients who underwent breast conserving surgery with TBR. The primary outcome was the esthetic result of the reconstruction, evaluated by both plastic surgeons and patients, at least 12 months after surgery.

Results

The aesthetic assessment was made in 42 patients. Overall, the clear majority of patients classified the outcome as good or perfect (95.2%), with less than 5% considering the outcome as mediocre. As for plastic surgeons, 83.3% were considered perfect/good outcomes, with 16.7% mediocre results. There were no poor results, neither for the patient nor the surgeon. There were no statistically significant associations between the esthetic result and tumor location nor its relation to the skin-resection pattern.

Conclusion

Aesthetic outcomes with this technique are promising, even when there is the need for technical modifications and despite the need for adjuvant radiotherapy, making it valuable for tumors in all locations.

Level of Evidence: Level III, risk / prognostic study.

Keywords

Breast Therapeutic breast reduction Oncoplastic surgery Esthetic outcome 

Notes

Compliance with ethical standards

Funding

The authors have no financial interest to declare in relation to the content of this article. No funding was received for this article.

Conflict of interest

Carolina Andresen, Augusta Cardoso, Cristina Cunha, João Morais, Gustavo Coelho, Maria da Luz Barroso, João Guimarães, and Horácio Costa declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained for all patients who were questioned and photographed in the outpatient consult. For the remaining patients, for this type of study formal consent is not required.

References

  1. 1.
    Hillberg NS, Meesters-Caberg MAJ, Beugels J, Winkens B, Vissers YLJ, van Mulken TJM (2018) Delay of adjuvant radiotherapy due to postoperative complications after oncoplastic breast conserving surgery. Breast 39:110–116CrossRefGoogle Scholar
  2. 2.
    Bertozzi N, Pesce M, Santi PL, Raposio E (2017) Oncoplastic breast surgery: comprehensive review. Eur Rev Med Pharmacol Sci 21(11):2572–2585PubMedGoogle Scholar
  3. 3.
    Barnea Y, Inbal A, Barsuk D, Menes T, Zaretski A, Leshem D, Weiss J, Schneebaum S, Gur E (2014) Oncoplastic reduction using the vertical scar superior-medial pedicle pattern technique for immediate partial breast reconstruction. Can J Surg 57(4):E134–E140CrossRefGoogle Scholar
  4. 4.
    Thiessen FEF, Tjalma WAA, Tondu T (2018) Breast reconstruction after breast conservation therapy for breast cancer. Eur J Obstet Gynecol Reprod Biol 230:233–238CrossRefGoogle Scholar
  5. 5.
    van Paridon MW, Kamali P, Paul MA, Wu W, Ibrahim AMS, Kansal KJ, Houlihan MJ, Morris DJ, Lee BT, Lin SJ, Sharma R (2017) Oncoplastic breast surgery: achieving oncological and aesthetic outcomes. J Surg Oncol 116(2):195–202CrossRefGoogle Scholar
  6. 6.
    Emiroglu M, Karaali C, Salimoglu S, Sert I, Aydın C (2016) Oncoplastic reduction mammoplasty for breast cancer in women with macromastia: long term aesthetic, functional and satisfaction outcomes. Contemp Oncol (Pozn) 20(3):256–260Google Scholar
  7. 7.
    Shin ES, Kim HI, Song SY, Lew DH, Lee DW (2018) Selection of oncoplastic surgical technique in Asian breast cancer patients. Arch Plast Surg 45(1):37–44CrossRefGoogle Scholar
  8. 8.
    Weber WP, Soysal SD, el-Tamer M, Sacchini V, Knauer M, Tausch C, Hauser N, Günthert A, Harder Y, Kappos EA, Schwab F, Fitzal F, Dubsky P, Bjelic-Radisic V, Reitsamer R, Koller R, Heil J, Hahn M, Blohmer JU, Hoffmann J, Solbach C, Heitmann C, Gerber B, Haug M, Kurzeder C (2017) First international consensus conference on standardization of oncoplastic breast conserving surgery. Breast Cancer Res Treat 165(1):139–149CrossRefGoogle Scholar
  9. 9.
    Weber WP, Soysal SD, Fulco I, Barandun M, Babst D, Kalbermatten D, Schaefer DJ, Oertli D, Kappos EA, Haug M (2017) Standardization of oncoplastic breast conserving surgery. Eur J Surg Oncol 43(7):1236–1243CrossRefGoogle Scholar
  10. 10.
    Shekhawat L, Busheri L, Dixit S, Patel C, Dhar U, Koppiker C (2015) Patient-reported outcomes following breast reconstruction surgery and therapeutic mammoplasty: prospective evaluation 1 year post-surgery with BREAST-Q questionnaire. Indian J Surg Oncol 6(4):356–362CrossRefGoogle Scholar
  11. 11.
    Rodriguez GJZ et al (2018) Oncoplastic surgery for the conservative treatment of breast cancer in Peru's National Cancer Institute. Ecancermedicalscience 12:815PubMedPubMedCentralGoogle Scholar
  12. 12.
    Crown A, Handy N, Rocha FG, Grumley JW (2018) Oncoplastic reduction mammaplasty, an effective and safe method of breast conservation. Am J Surg 215(5):910–915CrossRefGoogle Scholar
  13. 13.
    Acea-Nebril B, Cereijo-Garea C, García-Novoa A, Varela-Lamas C, Builes-Ramírez S, Bouzón-Alejandro A, Mosquera-Oses J (2017) The role of oncoplastic breast reduction in the conservative management of breast cancer: complications, survival, and quality of life. J Surg Oncol 115(6):679–686CrossRefGoogle Scholar
  14. 14.
    Di Micco R et al (2017) Standard wide local excision or bilateral reduction mammoplasty in large-breasted women with small tumours: surgical and patient-reported outcomes. Eur J Surg Oncol 43(4):636–641CrossRefGoogle Scholar
  15. 15.
    Hiller A et al (2018) Oncoplastic reduction pattern technique following removal of Giant Fibroadenoma. Eplasty 18:e4PubMedPubMedCentralGoogle Scholar
  16. 16.
    Buller M et al (2017) Immediate breast reconstruction of a nipple areolar lumpectomy defect with the L-flap skin paddle breast reduction design and contralateral reduction mammoplasty symmetry procedure: optimizing the Oncoplastic surgery multispecialty approach. Eplasty 17:e14PubMedPubMedCentralGoogle Scholar
  17. 17.
    Imahiyerobo TA, Pharmer LA, Swistel AJ, Talmor M (2015) A comparative retrospective analysis of complications after Oncoplastic breast reduction and breast reduction for benign Macromastia: are these procedures equally safe? Ann Plast Surg 75(4):370–375CrossRefGoogle Scholar
  18. 18.
    Challoner T, Skillman J, Wallis K, Vourvachis M, Whisker L, Hardwicke J (2017) Oncoplastic techniques: attitudes and changing practice amongst breast and plastic surgeons in Great Britain. Breast 34:58–64CrossRefGoogle Scholar
  19. 19.
    Piper ML, Esserman LJ, Sbitany H, Peled AW (2016) Outcomes following Oncoplastic reduction mammoplasty: a systematic review. Ann Plast Surg 76(Suppl 3):S222–S226CrossRefGoogle Scholar
  20. 20.
    Ettinger RE et al (2016) Bilateral reduction Mammaplasty as an Oncoplastic technique for the Management of Early-Stage Breast Cancer in women with Macromastia. Eplasty 16:e5PubMedPubMedCentralGoogle Scholar
  21. 21.
    Strasser EJ (1999) An objective grading system for the evaluation of cosmetic surgical results. Plast Reconstr Surg 104(7):2282–2285CrossRefGoogle Scholar
  22. 22.
    Losken A et al (2017) Oncoplastic Breast Reduction Technique and Outcomes: An Evolution over 20 Years. Plast Reconstr Surg 139(4):824e–833eCrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Plastic, Reconstructive and Craniomaxillofacial Microsurgery UnitCentro Hospitalar Vila Nova de Gaia/Espinho, Rua Conceição FernandesVila Nova de GaiaPortugal

Personalised recommendations