Oncoplastic reshaping in breast-conserving surgery in a peripheral hospital. The Novi Ligure "San Giacomo" hospital experience.

AIM: To confirm that oncoplastic approach to cancer is a fundamental part of modern breast conserving surgery also in a suburban hospital. MATERIAL OF STUDY: The Authors used oncoplastic techniques in 60 cases including 45 first level and 15 second level procedures: they show some cases of conservative surgery and breast reshaping with upper, medial and lower pedicle. DISCUSSION: Screening programs are able to identify early breast cancer; the breast conserving surgery with oncoplastic glandular reshaping should be an established custom to ensure oncological safety with the best cosmetic result. CONCLUSIONS: The oncoplastic approach to breast cancer should be the theoretical and practical knowledge of the breast surgeon. Today in fact the breast surgeon must be a "vertical surgeon" in order to treat cancer completely, interfaced with a multidisciplinary team to ensure a personalized treatment for each patient. In this presentation the Authors want to focus on oncoplastic surgery in a medium flow suburban hospital.

Use of oxidized and regenerated cellulose polymer in oncoplastic breast surgery.

AIM: The aim of this paper is evaluate the use of oxidized regenerated cellulose in order to control breast symmetry, shape and volume reducing skin retraction after wide excision for the treatment of early breast cancer. MATERIAL OF STUDY: The Authors describe a new procedure using oxidized regenerated cellulose polymer after 8 resections for breast cancer and 1 total galactophore ducts resection for nipple discharge. DISCUSSION: Oncoplastic breast surgery allows a more radical local tumour excision achieving an acceptable cosmetic result. Breast reshaping absorbs the volume loss and decreases the risk of a localized defect although there are zones that are at high risk of deformity. Once reabsorption of the seroma occurs, the excision cavity becomes prominent due to fibrosis and retraction of the surrounding tissue creating a noticeable defect. CONCLUSIONS: In oncoplastic breast surgery the oxidized regenerated cellulose by preventing the hematoma, can promote dermal fibroblasts proliferation and cell migration playing a role in adjustment of the shape, volume and symmetry of the breast and reducing skin retraction.

An example of lumpectomy for lower inner quadrant breast cancer with 1(st) level oncoplastic reconstruction by glandular splitting.

Oncoplastic techniques extend the scope for breast conserving surgery by combining an extensive local excision with a simultaneous reconstruction of the defect to avoid local deformity. If less than 20% of the breast volume is excised a level I procedure is adequate and can be performed by breast surgeon without specific training in plastic surgery. For breast cancer is possible to fill the defect of the lower inner lumpectomy by splitting the upper inner quadrant. The Authors describe a novel technique in giant breast.