Abstract
The management of partial mastectomy defects often requires rearrangement of local breast tissue or distant flaps to prevent a poor cosmetic result following radiation therapy. These partial breast reconstruction techniques have become a useful addition to breast conservation therapy and have been referred to as the oncoplastic approach. The oncoplastic reduction techniques are useful for women with large breasts requiring large resections or tumor resection in unfavorable locations. When poor cosmetic results are anticipated in women with smaller breasts, flap reconstructions are more often required to fill the defect. While outcomes are largely favorable, it is important to minimize complications to allow timely initiation of adjuvant therapies.
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References
Clough KB, et al. Cosmetic sequelae after conservative treatment for breast cancer: classification and results of surgical correction. Ann Plast Surg. 1998;41(5):471–81.
Kronowitz SJ, et al. Determining the optimal approach to breast reconstruction after partial mastectomy. Plast Reconstr Surg. 2006;117(1):1–11; discussion 12-4
Losken A, Hamdi M. Partial breast reconstruction: current perspectives. Plast Reconstr Surg. 2009;124(3):722–36.
Brierley JD, et al. The influence of breast size on late radiation reaction following excision and radiotherapy for early breast cancer. Clin Oncol (R Coll Radiol). 1991;3(1):6–9.
Pukancsik D, et al. Objective decision making between conventional and oncoplastic breast-conserving surgery or mastectomy: an aesthetic and functional prospective cohort study. Eur J Surg Oncol. 2017;43(2):303–10.
Cochrane R, et al. Cosmesis and satisfaction after breast-conserving surgery correlates with the percentage of breast volume excised. Br J Surg. 2003;90(12):1505–9.
Patel KM, et al. 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.
Munhoz AM, et al. Outcome analysis of immediate and delayed conservative breast surgery reconstruction with mastopexy and reduction mammaplasty techniques. Ann Plast Surg. 2011;67(3):220–5.
Kronowitz SJ, et al. A management algorithm and practical oncoplastic surgical techniques for repairing partial mastectomy defects. Plast Reconstr Surg. 2008;122(6):1631–47.
Egro FM, et al. The use of reduction mammaplasty with breast conservation therapy: an analysis of timing and outcomes. Plast Reconstr Surg. 2015;135(6):963e–71e.
Losken A, et al. The oncoplastic reduction approach to breast conservation therapy: benefits for margin control. Aesthet Surg J. 2014;34(8):1185–91.
Losken A, et al. Current opinion on the oncoplastic approach in the USA. Breast J. 2016;22(4):437–41.
Cao D, et al. Separate cavity margin sampling at the time of initial breast lumpectomy significantly reduces the need for reexcisions. Am J Surg Pathol. 2005;29(12):1625–32.
Clough KB, Kroll SS, Audretsch W. An approach to the repair of partial mastectomy defects. Plast Reconstr Surg. 1999;104(2):409–20.
Munhoz AM, et al. The role of the lateral thoracodorsal fasciocutaneous flap in immediate conservative breast surgery reconstruction. Plast Reconstr Surg. 2006;117(6):1699–710.
Munhoz AM, et al. Outcome analysis of breast-conservation surgery and immediate latissimus dorsi flap reconstruction in patients with T1 to T2 breast cancer. Plast Reconstr Surg. 2005;116(3):741–52.
Hamdi M, et al. Pedicled perforator flaps in breast reconstruction: a new concept. Br J Plast Surg. 2004;57(6):531–9.
Hamdi M, et al. The versatility of the inter-costal artery perforator (ICAP) flaps. J Plast Reconstr Aesthet Surg. 2006;59(6):644–52.
Spiegel AJ, Khan FN. An intraoperative algorithm for use of the SIEA flap for breast reconstruction. Plast Reconstr Surg. 2007;120(6):1450–9.
Losken A, et al. A meta-analysis comparing breast conservation therapy alone to the oncoplastic technique. Ann Plast Surg. 2014;72(2):145–9.
Losken A, et al. Oncoplastic breast reduction technique and outcomes: an evolution over 20 years. Plast Reconstr Surg. 2017;139(4):824e–33e.
Fitoussi AD, et al. Oncoplastic breast surgery for cancer: analysis of 540 consecutive cases [outcomes article]. Plast Reconstr Surg. 2010;125(2):454–62.
Khan J, et al. Oncoplastic breast conservation does not lead to a delay in the commencement of adjuvant chemotherapy in breast cancer patients. Eur J Surg Oncol. 2013;39(8):887–91.
Hart AM, et al. The psychosexual impact of partial and total breast reconstruction: a prospective one-year longitudinal study. Ann Plast Surg. 2015;75(3):281–6.
Veiga DF, et al. Quality-of-life and self-esteem outcomes after oncoplastic breast-conserving surgery. Plast Reconstr Surg. 2010;125(3):811–7.
Kelsall JE, et al. Comparing oncoplastic breast conserving surgery with mastectomy and immediate breast reconstruction: case-matched patient reported outcomes. J Plast Reconstr Aesthet Surg. 2017;70(10):1377–85.
Massa M, et al. Aesthetic evaluation in oncoplastic and conservative breast surgery: a comparative analysis. Plast Reconstr Surg Glob Open. 2015;3(3):e339.
Emiroglu M, et al. Oncoplastic reduction mammoplasty for breast cancer in women with macromastia: oncological long-term outcomes. Asian J Surg. 2017;40(1):41–7.
De Lorenzi F, et al. Oncoplastic breast-conserving surgery for tumors larger than 2 centimeters: is it oncologically safe? A matched-cohort analysis. Ann Surg Oncol. 2016;23(6):1852–9.
De Lorenzi F, et al. Oncological results of oncoplastic breast-conserving surgery: long term follow-up of a large series at a single institution: a matched-cohort analysis. Eur J Surg Oncol. 2016;42(1):71–7.
Mansell J, et al. Oncoplastic breast conservation surgery is oncologically safe when compared to wide local excision and mastectomy. Breast. 2017;32:179–85.
Acea-Nebril B, et al. The role of oncoplastic breast reduction in the conservative management of breast cancer: complications, survival, and quality of life. J Surg Oncol. 2017;115(6):679–86.
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Losken, A., Urquia, L.N. (2020). Partial Breast Reconstruction. In: Mayer, H. (eds) Breast Reconstruction. Springer, Cham. https://doi.org/10.1007/978-3-030-34603-4_2
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DOI: https://doi.org/10.1007/978-3-030-34603-4_2
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