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Nuove tecnologie chirurgiche in oncologia pp 91–107Cite as

Senologia oncologica e ricostruttiva

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Le innovazioni tecnologiche e tecniche hanno apportato notevoli cambiamenti sia nella chirurgia senologica oncologica, sia nella chirurgia ricostruttiva. Nel corso degli ultimi cinque anni ci sono stati importanti cambiamenti nel trattamento chirurgico del carcinoma della mammella e sono stati introdotti nella pratica clinica con una rapidità sempre crescente. La chirurgia conservativa ha impiegato circa vent’anni per essere accettata e applicata su larga scala e sono stati necessari 25 anni di pubblicazioni per dimostrarne la sicurezza oncologica [1]. La biopsia del linfonodo sentinella è stata introdotta come procedura di routine solo alcuni anni dopo la pubblicazione dei risultati preliminari. Quest’ultima è solo un esempio delle diverse tecniche e tecnologie introdotte negli ultimi cinque anni, tra le altre si annoverano la IORT, le nuove tecniche di localizzazione delle lesioni non palpabili, la nipple spearing mastectomy. Molti fattori possono spiegare questo rapido cambiamento. La diagnosi di tumori di sempre minori dimensioni ha rappresentato e rappresenta tuttora un importante stimolo allo sviluppo di tecniche chirurgiche sempre meno aggressive. L’approccio chirurgico e le tecniche in uso 10 anni fa non sono più applicabili oggi. Le pazienti sono consapevoli delle innovazioni acquisite e richiedono il trattamento “migliore”. La legge della domanda/offerta spinge ospedali e chirurghi a proporre terapie e trattamenti sempre più moderni. Questa spinta all’innovazione presenta però anche un risvolto negativo, l’applicazione clinica di nuove procedure sperimentali può in alcuni casi rivelarsi eccessiva soprattutto se i benefici di esse non sono ancora stati dimostrati e sono ancora in corso trial clinici.

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Bibliografia

  1. Fisher B, Jeong JH, Anderson S et al (2002) Twenty-five-year follow-up of a randomized trial comparing radical mastectomy, total mastectomy, and total mastectomy followed by irradiation. N Eng J Med 347: 567–575

    Article  Google Scholar 

  2. Manasseh DME, Willey SC (2006) Invasive carcinoma: mastectomy and staging the axilla. In: Spear SL (ed) Surgery of the breast. Vol. 1. 2nd edn. Lippincott Williams & Wilkins, Philadelphia, pp 132–139

    Google Scholar 

  3. Early Breast Cancer Trialists Collaborative Group (EBCTCG) (2005) Effect of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15 years survival: an overview of randomised trials. Lancet 366:2087–2106

    Google Scholar 

  4. Schwartz GF, Giuliano AE, Veronesi U (2002) The Consensus Conference Committee. In: Proceeding of the consensus conference on the role of sentinel node biopsy in carcinoma of the breast. April 19–22, 2001, Philadelphia. Cancer 94:2542–2551

    Article  PubMed  Google Scholar 

  5. Tafra L, Lannin DR, Swanson MS et al (2001) Multicenter trial of sentinel node biopsy for breast cancer using both technetium sulphur colloid and isosulfan blue dye. Ann Surg 233:51–59

    Article  PubMed  CAS  Google Scholar 

  6. Sandrucci S, Casalegno PS, Percivale P et al (1999) Sentinel lymph node mapping and biopsy for breast cancer: a review of the literature relative to 479 procedures. Tumori 85:425–434

    PubMed  CAS  Google Scholar 

  7. Simmons RM, Fish SK, Gayle L et al (1999) Local and distant recurrence rates in skin-sparing mastectomies compared with non-skin-sparing mastectomies. Ann Surg Oncol 6:676–681

    Article  PubMed  CAS  Google Scholar 

  8. Kroll SS, Khoo A, Singletary E et al (1999) Local recurrence risk after skin-sparing and conventional mastectomy: a 6-year follow-up. Plast Reconstr Surg 104:421–425

    Article  PubMed  CAS  Google Scholar 

  9. Toth BA, Forley BG, Calabria R (1999) Retrospective study of the skin-sparing mastectomy in breast reconstruction. Plast Reconstr Surg 104:77–84

    Article  PubMed  CAS  Google Scholar 

  10. Datta G, Carlucci S, Bussone R (2008) Star and comet incisions for skin sparing mastectomy. J Plast Reconstr Aesth Surg [Epub ahead of print]

    Google Scholar 

  11. Skoll PJ, Hudson DA (2002) Skin sparing mastectomy using a modified Wise pattern. Plast Reconstr Surg 110:214–217

    Article  PubMed  Google Scholar 

  12. Jabor MA, Shayani P, Collins DR Jr et al (2002) Nipple—areola reconstruction: satisfaction and clinical determinants. Plast Reconstr Surg 110:457–463

    Article  PubMed  Google Scholar 

  13. Chung AP, Sacchini V (2008) Nipple sparing mastectomy: where are we now? Surg Oncol 17:261–266

    Article  PubMed  Google Scholar 

  14. Simmons RM, Brennan M, Christos P et al (2002) Analysis of nipple areolar involvement with mastectomy: can the areola be preserved? Ann Surg Oncol 9:165–168

    Article  PubMed  Google Scholar 

  15. Petit JY, Veronesi U, Orecchia R et al (2006) Nipple-sparing mastectomy in association with intraoperative radiotherapy (ELIOT) a new type of mastectomy for breast cancer. Breast Cancer Res Treat 96:47–51

    Article  PubMed  Google Scholar 

  16. Regolo L, Ballardini B, Gallarotti E et al (2008) Nipple sparing mastectomy: an innovative skin incision for an alternative approach. Breast 17:8–11

    Article  PubMed  CAS  Google Scholar 

  17. Querci della Rovere G, Nava M, Bonomi R et al (2008) Skin reducing mastectomy with breast reconstruction and sub-pectoral implants. Plast Reconstr Surg 61:1303–1308

    Google Scholar 

  18. Grisotti A, Calabrese C (2006) Conservative treatment of breast cancer: reconstructive problems. In: Spear SL (ed) Surgery of the breast. Vol. 1. 2nd edn. Lippincott Williams & Wilkins, Philadelphia, pp 147–216

    Google Scholar 

  19. Clough KB, Lewis JS, Couturaud B et al (2003) Oncoplastic techniques allow extensive resections for breast conserving therapy of breast carcinomas. Ann Surg 237:26–34

    Article  PubMed  Google Scholar 

  20. Clough KB, Thomas SS, Couturaud B et al (2004) Reconstruction after conservative treatment for breast cancer: cosmetic sequelae classification revisited. Plast Reconstr Surg 114:1743–1753

    Article  PubMed  Google Scholar 

  21. Spear SL, Boehmler JH, Bogue DP, Mafi AA (2008) Options in reconstructing the irradiated breast. Plast Reconstr Surg 122:379–388

    Article  PubMed  CAS  Google Scholar 

  22. Petit JY, Rietjens M, Garusi C (2001) Breast reconstructive techniques in cancer patients: which ones, when to apply, which immediate and long term risks? Oncol Hematol 38:231–239

    CAS  Google Scholar 

  23. Richetti A (2008) Conventional, intraoperative, partial radiotherapy and aesthetic outcomes. In: Proceeding of conference on oncoplastic surgery of the breast cancer. Rapallo 20–21 Oct

    Google Scholar 

  24. Kronovitz SJ, Robb GL (2006) Controversies regarding immediate reconstruction: aesthetic risks of radiation. In: Spear SL (ed) Surgery of the breast. Vol. 1. 2nd edn. Lippincott Williams & Wilkins, Philadelphia, pp 679–699

    Google Scholar 

  25. Spear SL, Schwarz K (2006) Prosthetic reconstruction in radiated breast. In: Spear SL (ed) Surgery of the breast Vol. 1. 2nd edn. Lippincott Williams & Wilkins, Philadelphia, pp 515–530

    Google Scholar 

  26. Adams WP Jr, Potter JK (2006) Breast implant: materials and manufacturing past, present and future. In: Spear SL (ed) Surgery of the breast. Vol. 1. 2nd edn. Lippincott Williams & Wilkins, Philadelphia, pp 424–437

    Google Scholar 

  27. Missana MC, Laurent I, Barreau L, Balleyguier C (2007) Autologous fat transfer in reconstructive breast surgery: indications, technique and results. J Can Surg 33:685–690

    CAS  Google Scholar 

  28. Rigotti G, Marchi A, Galie M 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 119:1409–1422

    Article  PubMed  CAS  Google Scholar 

  29. Chan CW, McCulley SJ, Macmillan RD (2008) Autologous fat transfer — a review of the literature with a focus on breast cancer surgery. J Plast Reconstr Aesthet Surg 61:1438–1448

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. S.C.D.U. Chirurgia Plastica e Ricostruttiva, A.O.U. San Giovanni Battista di Torino, Torino, Italia

    S. Bruschi & P. Bogetti

  2. Breast Unit, Dipartimento di Chirurgia, A.O.U. San Giovanni Battista di Torino, Torino, Italia

    R. Bussone

Authors
  1. S. Bruschi
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  2. P. Bogetti
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  3. R. Bussone
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Bruschi, S., Bogetti, P., Bussone, R. (2011). Senologia oncologica e ricostruttiva. In: Nuove tecnologie chirurgiche in oncologia. Springer, Milano. https://doi.org/10.1007/978-88-470-2385-7_9

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  • DOI: https://doi.org/10.1007/978-88-470-2385-7_9

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-2384-0

  • Online ISBN: 978-88-470-2385-7

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