Abstract
Background: The combination of breast conserving surgery (BCS) with plastic surgery techniques has provided a useful surgical tool matching the radicality of the oncological excision with the preservation of breast cosmesis. Even though BCS represents a good option for surgical treatment of tumors located in these quadrants, wide excisions often necessitate breast reshaping in order to avoid nipple areola complex (NAC) displacement and skin retraction. We present a new surgical technique to repair upper-outer quadrants' defects following breast cancer excision using dermo-glandular flaps and an axillary adipo-fascial flap. Methods: During the period from January 2014 to December 2015, 168 patients with an upper-outer quadrant's breast cancer have been treated in our Department. 83 women have been treated with the described oncoplastic technique and immediate contra-lateral symmetrisation and 85 women underwent standard BCS. We present surgical, oncological and cosmetic outcomes comparing our results with standard BCS. Results: At a mean follow-up of 27 months loco-regional recurrences in the two groups were comparable. Short-term complication rates were comparable between the two groups. Re-intervention rates for positive margins were significantly higher in the standard BCS group. The overall satisfaction with cosmetic outcome both assessed by the patient and the surgeon was significantly higher in the oncoplastic group. Conclusions: The proposed oncoplastic technique represents a safe and effective solution for reshaping that follows upper-outer breast cancer wide excision, achieving comparable complication rates, lower re-intervention rates for positive margins and better cosmetic results when compared with standard BCS.
| Original language | English |
|---|---|
| Article number | 21 |
| Journal | BMC Surgery |
| Volume | 18 |
| DOIs | |
| Publication status | Published - Jan 1 2019 |
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Keywords
- Breast Cancer
- Oncoplastic breast surgery
- Surgical technique
ASJC Scopus subject areas
- Surgery
Cite this
The axillary flap in oncoplastic resection of breast cancers located in the upper-outer quadrants : A new surgical technique. / Bordoni, Daniele; Cadenelli, Pierfrancesco; Ornelli, Matteo; Falco, Giuseppe; Accurso, Antonello; Gloria, Antonio; Maietta, Saverio; Rocco, Nicola; Magalotti, Cesare.
In: BMC Surgery, Vol. 18, 21, 01.01.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The axillary flap in oncoplastic resection of breast cancers located in the upper-outer quadrants
T2 - A new surgical technique
AU - Bordoni, Daniele
AU - Cadenelli, Pierfrancesco
AU - Ornelli, Matteo
AU - Falco, Giuseppe
AU - Accurso, Antonello
AU - Gloria, Antonio
AU - Maietta, Saverio
AU - Rocco, Nicola
AU - Magalotti, Cesare
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Background: The combination of breast conserving surgery (BCS) with plastic surgery techniques has provided a useful surgical tool matching the radicality of the oncological excision with the preservation of breast cosmesis. Even though BCS represents a good option for surgical treatment of tumors located in these quadrants, wide excisions often necessitate breast reshaping in order to avoid nipple areola complex (NAC) displacement and skin retraction. We present a new surgical technique to repair upper-outer quadrants' defects following breast cancer excision using dermo-glandular flaps and an axillary adipo-fascial flap. Methods: During the period from January 2014 to December 2015, 168 patients with an upper-outer quadrant's breast cancer have been treated in our Department. 83 women have been treated with the described oncoplastic technique and immediate contra-lateral symmetrisation and 85 women underwent standard BCS. We present surgical, oncological and cosmetic outcomes comparing our results with standard BCS. Results: At a mean follow-up of 27 months loco-regional recurrences in the two groups were comparable. Short-term complication rates were comparable between the two groups. Re-intervention rates for positive margins were significantly higher in the standard BCS group. The overall satisfaction with cosmetic outcome both assessed by the patient and the surgeon was significantly higher in the oncoplastic group. Conclusions: The proposed oncoplastic technique represents a safe and effective solution for reshaping that follows upper-outer breast cancer wide excision, achieving comparable complication rates, lower re-intervention rates for positive margins and better cosmetic results when compared with standard BCS.
AB - Background: The combination of breast conserving surgery (BCS) with plastic surgery techniques has provided a useful surgical tool matching the radicality of the oncological excision with the preservation of breast cosmesis. Even though BCS represents a good option for surgical treatment of tumors located in these quadrants, wide excisions often necessitate breast reshaping in order to avoid nipple areola complex (NAC) displacement and skin retraction. We present a new surgical technique to repair upper-outer quadrants' defects following breast cancer excision using dermo-glandular flaps and an axillary adipo-fascial flap. Methods: During the period from January 2014 to December 2015, 168 patients with an upper-outer quadrant's breast cancer have been treated in our Department. 83 women have been treated with the described oncoplastic technique and immediate contra-lateral symmetrisation and 85 women underwent standard BCS. We present surgical, oncological and cosmetic outcomes comparing our results with standard BCS. Results: At a mean follow-up of 27 months loco-regional recurrences in the two groups were comparable. Short-term complication rates were comparable between the two groups. Re-intervention rates for positive margins were significantly higher in the standard BCS group. The overall satisfaction with cosmetic outcome both assessed by the patient and the surgeon was significantly higher in the oncoplastic group. Conclusions: The proposed oncoplastic technique represents a safe and effective solution for reshaping that follows upper-outer breast cancer wide excision, achieving comparable complication rates, lower re-intervention rates for positive margins and better cosmetic results when compared with standard BCS.
KW - Breast Cancer
KW - Oncoplastic breast surgery
KW - Surgical technique
UR - http://www.scopus.com/inward/record.url?scp=85065335777&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85065335777&partnerID=8YFLogxK
U2 - 10.1186/s12893-018-0467-3
DO - 10.1186/s12893-018-0467-3
M3 - Article
AN - SCOPUS:85065335777
VL - 18
JO - BMC Surgery
JF - BMC Surgery
SN - 1471-2482
M1 - 21
ER -