Oncoplasty for breast carcinoma

ABSTRACT

To assess the oncologic and cosmetic outcomes in women with breast carcinoma who were treated with breast-conserving surgery using oncoplastic techniques with concomitant symmetrization of the contra lateral breast. Although breast-conserving surgery is the standard form of treatment for invasive breast tumors up to 4cm, cosmetic results may be poor and clear resection margins difficult to obtain in patients with large, ill-defined, or poorly situated tumors. The integration of oncoplastic techniques with or without a concomitant contralateral symmetrization procedure is a novel surgical approach that combines both oncologic and plastic surgical procedures and allows wide excisions and prevents breast deformities. This is a prospective study of 32 patients who were operated on for breast carcinoma between August 2004 and Mars 2006 by the author. The procedure was proposed for patients in whom conservative treatment was possible on oncologic grounds but where a standard lumpectomy would have led to poor cosmetic outcomes. Standard treatment protocols were followed. All patients received postoperative radiotherapy except 2. Mean follow-up was 1.5 years. They were compared to a control group including 43 patients with the same inclusion criteria. Mean weight of excised material on the tumor side was 393 g. The actuarial 2-year local recurrence rate was about 6%, contra lateral procedure was needed in 10%. Cosmoses was favorable in 88% of cases. The use of oncoplastic techniques with or without concomitant symmetrization of the contra lateral breast allows extensive resections for the treatment of breast carcinoma and results in favorable both oncologic and esthetic outcomes. This approach might be useful in extending the indications for conservative breast therapy