Share This Article:

Oncoplasty’s Contribution in Breast Cancers: About 48 Cases

DOI: 10.4236/oalib.1101330    218 Downloads   359 Views  

ABSTRACT

Introduction: Oncoplasty has developed for 20 years in order to avoid potentially major deformations of conservative treatment. We report the results of our oncoplastic breast operations. Patients and Methods: We conducted a descriptive and retrospective study of 48 patients treated by oncoplastic technique in the national center of burn and plastic surgery in the U.H. IBN-ROCHD of Casablanca between 2011 and 2014. Patient and tumor characteristics, as well as information on the procedures and complications, were collected from clinical records. Results: Forty-eight cases were reviewed. The tumors were processed for the majority of invasive ductal carcinoma pT2. Seven patients had an inadequate surgical margin. About histology, the rate of recovery for non-positive margins was significantly lower in the CCI alone than that in other types. Morbidity was 14.5% and the average delayed to adjuvant treatment of 72 days. The symmetrization rate was 24%. In terms of oncological results, during a median follow-up of 22 months, the rate of local recurrences was 13%. Conclusion: The oncoplastic operations offer tools for breast conservation in patients and otherwise is destined for mastectomy or poor esthetic outcome. This study shows that the goal of surgical therapy is to identify patients who are suitable for oncoplastic surgery. Proper pre-operative evaluation and diagnosis, surgical planning, adequacy of resection, and pathological evaluation are essential.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Rafik, A. , Douiri, M. , Bahechar, N. and Chlihi, A. (2015) Oncoplasty’s Contribution in Breast Cancers: About 48 Cases. Open Access Library Journal, 2, 1-6. doi: 10.4236/oalib.1101330.

References

[1] Meretoja, T.J., Svarvar, C. and Jahkola, T.A. (2010) Outcome of Oncoplastic Breast Surgery in 90 Prospective Patients. The American Journal of Surgery, 200, 224-228.
http://dx.doi.org/10.1016/j.amjsurg.2009.09.026
[2] McCulley, S.J. and Macmillan, R.D. (2005) Therapeutic Mammoplasty-Analysis of 50 Consecutive Cases. British Journal of Plastic Surgery, 58, 902-907.
http://dx.doi.org/10.1016/j.bjps.2005.03.007
[3] Cothier-Savey, I., Rimareix, F. and Belichard, C. (2011) Principes généraux de la chirurgie oncoplastique et de la reconstruction mammaire immédiate et différée.
http://www.em-premium.com.doc-distant.univ-lille2.fr/article/20722
[4] Clough, K.B., Nos, C., Fitoussi, A., Couturaud, B., Inguenault, C. and Sarfati, I. (2008) Séquelles esthétiques du traitement conservateur des cancers du sein: Une classification pour les reconstructions après tumorectomie. Annales de Chirurgie Plastique Esthétique, 53, 88-101.
http://dx.doi.org/10.1016/j.anplas.2008.01.001
[5] Clough, K.B., Kaufman, G.J., Nos, C., Buccimazza, I. and Sarfati, I.M. (2010) Improving Breast Cancer Surgery: A Classification and Quadrant per Quadrant Atlas for Oncoplastic Surgery. Annals of Surgical Oncology, 17, 1375-1391.
http://dx.doi.org/10.1245/s10434-009-0792-y
[6] Benelli, L. (1990) A New Periareolar Mammaplasty: The “Round Block” Technique. Aesthetic Plastic Surgery, 14, 93-100.
http://dx.doi.org/10.1007/BF01578332
[7] Garrido, I., Gangloff, D., Trocard, P., Wagner, A., Rafii, A., Chopin, N., et al. (2006) Les bonnes indications de l’oncoplastie. Oncologie, 8, 714-723.
http://dx.doi.org/10.1007/s10269-006-0495-y
[8] Veronesi, U., Cascinelli, N., Mariani, L., Greco, M., Saccozzi, R., Luini, A., et al. (2002) Twenty-Year Follow-Up of a Randomized Study Comparing Breast-Conserving Surgery with Radical Mastectomy for Early Breast Cancer. New England Journal of Medicine, 347, 1227-1232.
http://dx.doi.org/10.1056/NEJMoa020989
[9] Wolmark, N., Wang, J., Mamounas, E., Bryant, J. and Fisher, B. (2001) Preoperative Chemotherapy in Patients with Operable Breast Cancer: Nine-Year Results from National Surgical Adjuvant Breast and Bowel Project B-18. Journal of the National Cancer Institute Monographs, 30, 96-102.
http://dx.doi.org/10.1093/oxfordjournals.jncimonographs.a003469
[10] Rietjens, M., Urban, C.A., Rey, P.C., Mazzarol, G., Maisonneuve, P., Garusi, C., et al. (2007) Long-Term Oncological Results of Breast Conservative Treatment with Oncoplastic Surgery. Breast, 16, 387-395.
http://dx.doi.org/10.1016/j.breast.2007.01.008
[11] Staub, G., Fitoussi, A., Falcou, M-C. and Salmon, R-J. (2008) Résultats carcinologiques et esthétiques du traitement du cancer du sein par plastie mammaire. 298 cas. Annales de Chirurgie Plastique Esthétique, 53, 124-134.
http://dx.doi.org/10.1016/j.anplas.2007.05.012
[12] Berry, M.G., Fitoussi, A.D., Curnier, A., Couturaud, B. and Salmon, R.J. (2010) Oncoplastic Breast Surgery: A Review and Systematic Approach. Journal of Plastic, Reconstructive & Aesthetic Surgery, 63, 1233-1243.
http://dx.doi.org/10.1016/j.bjps.2009.05.006
[13] Naveau, A., Kane, A. and Rimareix, F. (2012) Place de l’oncoplastie dans le traitement des cancers du sein traités par chimiothérapie néo-adjuvante. Cancer du sein: Surdiagnostic, surtraitement. Springer, Paris, 396-397.
[14] Spear, S.L., Pelletiere, C.V., Wolfe, A.J., Tsangaris, T.N. and Pennanen, M.F. (2003) Experience with Reduction Mammaplasty Combined with Breast Conservation Therapy in the Treatment of Breast Cancer. Plastic & Reconstructive Surgery, 111, 1102-1109.
http://dx.doi.org/10.1097/01.PRS.0000046491.87997.40
[15] Fisher, B., Anderson, S., Bryant, J., Margolese, R.G., Deutsch, M., Fisher, E.R., et al. (2002) Twenty-Year Follow-Up of a Randomized Trial Comparing Total Mastectomy, Lumpectomy, and Lumpectomy Plus Irradiation for the Treatment of Invasive Breast Cancer. The New England Journal of Medicine, 347, 1233-1241.
http://dx.doi.org/10.1056/NEJMoa022152
[16] Pezner, R.D., Tan, M.C., Clancy, S.L., Chen, Y-J., Joseph, T. and Vora, N.L. (2013) Radiation Therapy for Breast Cancer Patients Who Undergo Oncoplastic Surgery: Localization of the Tumor Bed for the Local Boost. American Journal of Clinical Oncology, 36, 535-539.
http://dx.doi.org/10.1097/COC.0b013e318256efba
[17] Yang, S.H., Yang, K.H., Li, Y.P., Zhang, Y.C., He, X.D., Song, A.L., et al. (2008) Breast Conservation Therapy for Stage I or Stage II Breast Cancer: A Meta-Analysis of Randomized Controlled Trials. Annals of Oncology, 19, 1039-1044.
http://dx.doi.org/10.1093/annonc/mdm573
[18] Achard, E. and Salmon, R.J. (2007) Reduction Mammoplasty in Breast Cancers of the Lower Quadrants. Bulletin du Cancer, 94, 225-228.
[19] Kaur, N., Petit, J-Y., Rietjens, M., Maffini, F., Luini, A., Gatti, G., et al. (2005) Comparative Study of Surgical Margins in Oncoplastic Surgery and Quadrantectomy in Breast Cancer. Annals of Surgical Oncology, 12, 539-545.
http://dx.doi.org/10.1245/ASO.2005.12.046
[20] Losken, A., Styblo, T.M., Carlson, G.W., Jones, G.E. and Amerson, B.J. (2007) Management Algorithm and Outcome Evaluation of Partial Mastectomy Defects Treated Using Reduction or Mastopexy Techniques. Annals of Plastic Surgery, 59, 235-242.
http://dx.doi.org/10.1097/SAP.0b013e31802ec6d1
[21] Olson, T.P., Harter, J., Muñoz, A., Mahvi, D.M. and Breslin, T. (2007) Frozen Section Analysis for Intraoperative Margin Evaluation during Breast-Conserving Surgery Results in Low Rates of Re-Excision and Local Recurrence. Annals of Surgical Oncology, 14, 2953-2960.
http://dx.doi.org/10.1245/s10434-007-9437-1
[22] Iwuchukwu, O.C., Harvey, J.R., Dordea, M., Critchley, A.C. and Drew, P.J. (2012) The Role of Oncoplastic Therapeutic Mammoplasty in Breast Cancer Surgery—A Review. Surgical Oncology, 21, 133-141.
http://dx.doi.org/10.1016/j.suronc.2011.01.002

  
comments powered by Disqus

Copyright © 2018 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.