A Consensus Definition and Classification System of Oncoplastic Surgery Developed by the American Society of Breast Surgeons
- 444 Downloads
Several definitions of oncoplastic surgery have been reported in the literature. In an effort to facilitate communication regarding oncoplastic surgery to patients, trainees, and among colleagues, the American Society of Breast Surgeons (ASBrS) aimed to create a consensus definition and classification system for oncoplastic surgery.
We performed a comprehensive literature search for oncoplastic surgery definitions using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Following this, a consensus definition and classification system was created by the ASBrS.
Overall, 30 articles defining oncoplastic surgery were identified, with several articles contradicting each other. The ASBrS definition for oncoplastic surgery defines this set of breast-conserving operations using volume displacement and volume replacement principles as: “Breast conservation surgery incorporating an oncologic partial mastectomy with ipsilateral defect repair using volume displacement or volume replacement techniques with contralateral symmetry surgery as appropriate”. Volume displacement is defined as closing the lumpectomy defect and redistributing the resection volume over the preserved breast, and is divided into two levels: level 1 (< 20%) and level 2 (20–50%). Volume replacement includes those situations when volume is added using flaps or implants to correct the partial mastectomy defect.
The ASBrS oncoplastic surgery definition and classification system provides language to facilitate discussion and teaching of oncoplastic surgery among breast surgeons, trainees, and patients.
- 1.SEER Cancer Statistics Review, 1975–2015. National Cancer Institute. 2018 [cited 21 Sep 2018]. https://seer.cancer.gov/csr/1975_2015/.
- 2.American College of Surgeons. Cancer Program Standards: Ensuring Patient-Centered Care (2016 edition). Chicago: American College of Surgeons; 2016. pp. 58–9.Google Scholar
- 3.American College of Surgeons. National accreditation program for breast centers standards manual. Chicago: American College of Surgeons; 2018. pp. 58–60.Google Scholar
- 6.Gass J, Mitchell S, Hanna M. The psychosocial impact of surgical scars in survivorship: findings from a nationwide survey of women breast cancer survivors [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 5–9 Dec 2017; San Antonio, TX.Google Scholar
- 22.Institute of Medicine and National Research Council. From cancer patient to cancer survivor: lost in transition. Washington, DC: The National Academies Press; 2006.Google Scholar
- 27.Petit JY, Lohsiriwat V, Clough KB, Sarfati I, Ihrai T, Rietjens M, et al. The oncologic outcome and immediate surgical complications of lipofilling in breast cancer patients: a multicenter study—Milan–Paris–Lyon experience of 646 lipofilling procedures. Plast Reconstr Surg. 2011;128(2):341–6.CrossRefGoogle Scholar
- 33.Chatterjee A, Asban A, Jonczyk M, Chen L, Czerniecki B, Fisher CS. A cost-utility analysis comparing large volume displacement oncoplastic surgery to mastectomy with free flap reconstruction in the treatment of breast cancer. Am J Surg. 2019;41:159. https://doi.org/10.1016/j.amjsurg.2019.01.037CrossRefGoogle Scholar
- 49.Franceschinin G, Magno S, Fabbri C. Conservative and radical oncoplastic approaches in the surgical treatment of breast cancer. Eur Rev Med Pharmacol Sci. 2008;12(6):387–96.Google Scholar
- 51.Hoffmann J, Wallwiener D. Classifying breast cancer surgery: a novel, complexity-based system for oncological, oncoplastic and reconstructive procedures, and proof of principle by analysis of 1225 operations in 1166 patients. MC Cancer. 2009;9:108.Google Scholar
- 58.Perez R. Incision patterns in breast oncoplastic surgery. 2015. http://hdl.handle.net/10902/7059.