Planning and use of oncoplastic surgery for breast cancer

Abstract

Today, breast conserving surgery among women with different stages of breast cancer is increasing. In addition, these operations do not differ in oncological radicality and do not show differences in relation to survival compared to mastectomy, but their cosmetic and psychological benefits are significant. In search of a balance between the risk of local recurrence and cosmetic results in surgical interventions in breast cancer, new surgical variants were introduced – a combination of breast conserving surgery with plastic surgery, so-called oncoplastic surgery. Oncoplastic surgery has been widely developed in the surgical treatment of breast cancer in the last decade. In oncoplastic breast surgery, the tumors of the upper-inner quadrant of the breast are problematic and require more attention of the surgeon. In these cases the size and location of the tumor are two important factors for the post-operative cosmetic outcome. In this article we introduce a modified dermoglandular rotation flap technique, which can be applied for relatively large tumors of inner quadrant of the breast without surgery of the contralateral breast for symmetrical effect. With this technique, a larger breast tumor could be removed without compromising the breast appearance. An important aspect of breast conserving surgery is preoperative evaluation of the clinical and biological features of the tumor as well as the morphological aspects of tumor allow the surgeon to make a decision if a conservative is possible and select the most effective oncoplastic surgical technique. Oncoplastic techniques may improve cosmetic view and patient satisfaction without compromising the oncological outcomes, which is confirms the clinical utility of this approach to the surgical management of patients with breast cancer. The article also presents clinical cases – 46 years old patient with left breast cancer (stage I cT1N0M0 pT1N0M0) and a patient of 42 years old with right breast cancer (stage I cT1NXM0 pT1N0M0) in the treatment of which the described technique was applied.