Advertisement

Delayed Reconstruction After Breast-Conserving Surgery

  • Eduardo G. González
Chapter

Abstract

Oncoplastic surgery was incorporated into the primary treatment of breast cancer to prevent the damaging consequences of this treatment and produce a significant benefit both aesthetically and psychologically without altering the oncological safety. In the conservative treatment, although there are many reconstructive techniques to prevent sequelae, for different reasons there are a number of patients with unsatisfactory results magnified by the effects of radiotherapy. Traditionally, aggressive techniques with high rates of complication (autologous tissue, prosthetic) and unstable results were used for the reconstruction of these defects; however, in recent years the introduction of lipotransference opened up a promising new stage, achieving results in many cases that are highly satisfactory, stable, and with lower morbidity.

Keywords

Breast cancer Breast surgery Breast conservative treatment Oncoplastic techniques Breast cosmetic sequelae Radiotherapy Late sequelae Breast reconstruction Delayed breast reconstruction Latissimus dorsi flap Transverse rectus abdominis myocutaneous flap Deep inferior epigastric perforator flap Local flaps Fat grafting Quality of life 

References

  1. 1.
    Audretsch W et al (1994) Oncoplastic surgery: “target” volume reduction, (BCT mastopexy) lumpectomy reconstruction (BCT reconstruction) and flap supported operability in breast cancer. In: Proceedings of the second European congress on senology, Vienna, Austria. Monduzzi, Bologna, pp 139–157Google Scholar
  2. 2.
    Silverstein M (1993) Cosmetic quadrantectomy. Paper presented at the annual Miami breast cancer conference, MiamiGoogle Scholar
  3. 3.
    Clough K et al (1995) Conservative treatment of the breast cancer by mammaplasty and irradiation: a new approach to lower quadrant tumors. Plast Reconstr Surg 96:363–370CrossRefGoogle Scholar
  4. 4.
    Grisotti A (1994) Immediate reconstruction after partial mastectomy. Oper Tech Plast Reconstr Surg 1:1–12CrossRefGoogle Scholar
  5. 5.
    Audretsch W et al (1998) Tumor-specific immediate reconstruction (TSIR) in breast cancer patients. Perspect Plast Surg 11:71–106Google Scholar
  6. 6.
    Veronessi U et al (1995) Breast conservation is a safe method in patients with small cancer of the breast. Long term results of three randomized trials on 1973 patients. Eur J Cancer 31A(10):1574–1579CrossRefGoogle Scholar
  7. 7.
    Fisher B et al (1995) Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the 541 treatment of breast cancer. N Engl J Med 333:1456–1461CrossRefGoogle Scholar
  8. 8.
    Moody A et al (1994) The influence of breast size on late radiation effects and association with radiotherapy dose inhomogeneity. Radiother Oncol 33:106–112 545CrossRefGoogle Scholar
  9. 9.
    Gray J et al (1991) Primary breast irradiation in large breasted or heavy women: analysis of cosmetics outcome. Int J Radiat Oncol Biol Phys 21:347–354CrossRefGoogle Scholar
  10. 10.
    Clough K et al (1998) Cosmetic sequelae after conservative treatment for breast cancer: classification and results of surgical correction. Ann Plast Surg 41:471–481CrossRefGoogle Scholar
  11. 11.
    Biazus JV, Falcão CC, Parizotto AC et al (2015) Immediate reconstruction with autologous fat transfer following breast-conserving surgery. Breast J 21(3):268–275CrossRefGoogle Scholar
  12. 12.
    Cardoso M et al (2007) Factors determining esthetic outcome after breast cancer conservative treatment. Breast J 13(2):140–146CrossRefGoogle Scholar
  13. 13.
    Bartelink H et al (2001) Recurrence rates after treatment of breast cancer with standard radiotherapy with or without additional radiation. N Engl J Med 345(19):1378–1387CrossRefGoogle Scholar
  14. 14.
    Markiewicz D et al (1996) The effects of sequence and type of chemotherapy and radiation therapy on cosmesis and complications after breast conservation therapy. Int J Radiat Oncol Biol Phys 35(4):661–668CrossRefGoogle Scholar
  15. 15.
    Hoeller U (2003) Cosmesis from the patient’s and the doctor’s view. Int J Radiat Oncol Biol Phys 57(2):345–354CrossRefGoogle Scholar
  16. 16.
    Moyer HR et al (2008) Three-dimensional digital evaluation of breast symmetry after breast conservation therapy. J Am Coll Surg 207(2):227–232 565CrossRefGoogle Scholar
  17. 17.
    Fitzal F et al (2007) The use of a breast symmetry index for objective evaluation of breast cosmesis. Breast 16(4):429–435CrossRefGoogle Scholar
  18. 18.
    Berrino P (1987) Postquadrantectomy breast deformities: classification and techniques of surgical correction. Plast Reconstr Surg 79(4):567–572CrossRefGoogle Scholar
  19. 19.
    Fitoussi A et al (2010) Management of the post-breast-conserving therapy defect: extended follow-up and reclassification. Plast Reconstr Surg 125(3):783–791CrossRefGoogle Scholar
  20. 20.
    Winters Z et al (2010) A systematic review of the clinical evidence to guide treatment recommendations in breast reconstruction based on patient-reported outcome measures and health-related quality of life. Ann Surg 252:929–942CrossRefGoogle Scholar
  21. 21.
    Kronowitz S et al (2008) A management algorithm and practical oncoplastic surgical techniques for repairing partial mastectomy defects. Plast Reconstr Surg 122:1631 584Google Scholar
  22. 22.
    ASPRS Ad-Hoc Committee on New Procedures Report on autologous fat transplantation. Plast Surg Nurs 7:140Google Scholar
  23. 23.
    Rigotti G et al (2007) Clinical treatment of radiotherapy tissue damage by lipoaspirate transplant: a healing process mediated by adipose-derived adult stem cells. Plast Reconstr Surg 119(5):1409–1422; discussion 1423–1424CrossRefGoogle Scholar
  24. 24.
    Gutowski K et al (2009) Current applications and safety of autologous fat grafts: a report of the ASPS Fat Graft Task Force. Plast Reconstr Surg 124:272CrossRefGoogle Scholar
  25. 25.
    Khouri R (2000) Nonsurgical breast enlargement using an external soft-tissue expansion system. Plast Reconstr Surg 105:2500–2512CrossRefGoogle Scholar
  26. 26.
    Delay E (1998) Autologous latissimus breast reconstruction: a 3 year clinical experience with 100 patients. Plast Reconstr Surg 102:1461–1478CrossRefGoogle Scholar
  27. 27.
    Moran S et al (2000) Immediate free TRAM reconstruction in lumpectomy and radiation failure patients. Plast Reconstr Surg 106(7):1527–1531CrossRefGoogle Scholar
  28. 28.
    González E et al (2006) Utilidad y sistematización de las técnicas de cirugía oncoplástica en la prevención y corrección de las secuelas del tratamiento conservador. Consideraciones oncológicas y cosméticas. Rev Arg Mastol 25(86):49–69Google Scholar
  29. 29.
    Clough K et al (2003) Oncoplastic techniques allow extensive resections for breast-conserving therapy of breast carcinomas. Ann Surg 237(1):26–34CrossRefGoogle Scholar
  30. 30.
    González E et al (2010) Evaluación clínica de la corrección de los defectos post tratamiento conservador y mastectomía con radioterapia con o sin reconstrucción mamaria con autotransferencia de tejido adiposo sin manipulación de stem cells. Revista XXVI Jornadas Nacionales de Oncología del Instituto “Ángel H. Roffo”, 31 de agosto al 3 de septiembre de 2010Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Eduardo G. González
    • 1
  1. 1.Division Mastology DepartmentInstituto de Oncología “Angel H. Roffo”, Universidad de Buenos AiresCiudad Autónoma de Buenos Aires (CABA)Argentina

Personalised recommendations