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. 2018 Sep;9(3):300-306.
doi: 10.1007/s13193-017-0689-3. Epub 2017 Aug 15.

Oncologic and Cosmetic Outcomes of Oncoplastic Breast Surgery in Locally Advanced Breast Cancer After Neoadjuvant Chemotherapy, Experience from a Developing Country

Mina M G Youssef  1 , Alfred Namour  2 , Omar Z Youssef  1 , Ahmed Morsi  1
Affiliations

Oncologic and Cosmetic Outcomes of Oncoplastic Breast Surgery in Locally Advanced Breast Cancer After Neoadjuvant Chemotherapy, Experience from a Developing Country

Mina M G Youssef et al. Indian J Surg Oncol. 2018 Sep.

Abstract

Oncoplastic surgery (OPS) has emerged as a new approach for extending breast conserving surgery (BCS) possibilities, reducing both mastectomy and re-excision rates, while avoiding breast deformities. OPS is based upon the integration of plastic surgery techniques for immediate reshaping after wide excision for breast cancer. This is a prospective feasibility cohort study of oncoplastic breast surgery after neoadjuvant chemotherapy that was carried at the National Cancer Institute, Cairo University and included 70 patients. The primary outcome was the local recurrence rate. Secondary outcomes included survival and margins obtained as well as cosmetic outcomes. Survival analysis was performed. Oncoplastic breast surgery did not compromise oncologic safety in the patients included in the study. It even allowed wider margins of resection which could be associated with better oncologic outcomes. At the same time, it gave a better cosmetic outcome and therefore higher patient satisfaction. Oncoplastic breast surgery includes a wide spectrum of surgical techniques, ranging from the basic level I techniques in breast conserving surgery to the more complex procedures of level II which are broadly classified into volume replacement (therapeutic mammoplasty) and volume displacement procedures. We suggest that oncoplastic breast surgery techniques should be the standard of care in breast surgery. They are the basis for breast conserving surgery techniques in early breast cancer. In our experience, oncoplastic surgery is feasible in locally advanced tumours after downstaging with neoadjuvant chemotherapy without compromising the oncologic safety.

Keywords: Breast; Egypt; Neoadjuvant Chemotherapy; Oncoplastic Surgery; Safety.

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Conflict of interest statement

The authors declare there is no conflict of interest in this article.Ethical approval was obtained by the Ethics Committee at the National Cancer Institute, Cairo University, April 2011.

Figures

Fig. 1
Fig. 1
DFS with types of OPS
Fig. 2
Fig. 2
DFS with margins
Fig. 3
Fig. 3
Cosmetic outcome after level I OPS
Fig. 4
Fig. 4
Cosmetic outcome after level II OPS. Superior pedicle therapeutic mammoplasty
Fig. 5
Fig. 5
Cosmetic outcome after mini LD flap for volume replacement
Fig. 6
Fig. 6
Cosmetic outcome after level II OPS. Grisotti flap for central tumour and immediate nipple reconstruction
Fig. 7
Fig. 7
Cosmetic outcome after level II OPS. Inferior pedicle therapeutic mammoplasty (left) and contralateral reduction mammoplasty
Fig. 8
Fig. 8
Cosmetic outcome after level II OPS. Volume replacement with mini LD flap for UIQ tumour who had minimal clinical response
See this image and copyright information in PMC

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