La place de la chirurgie plastique dans le traitement conservateur du cancer du sein

Translated title of the contribution: The place of plastic surgery in consecutive treatment of breast cancer

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Conservative surgery (CS) is widely accepted today as the treatment of choice for 60 to 80% of the primary breast cancer. Esthetic results of CS are not good in all the cases and improvement can be obtained thanks to the remodelling of the breast after tumorectomy. The scar should be selected according to the location of the tumor; the glandular tissue should be reshaped using local glandular flaps or following the principles of the reduction mammaplasties. Tumorectomy located in the upper part of the gland can be reshaped with an inferior pedicle type of mammoplasty. Defect located in the inferior part of the gland can be reconstructed with a superior pedicle mammoplasty. These sophisticated tumorectomies are providing good esthetic results on the reconstructed breast but require commonly a symmetry procedure on the contralateral breast. Such contralateral reduction allows a better exploration of the opposite breast and histological examination of the reduction specimen. In a series of 76 CS performed at the European Institute of Oncology (IEO), which were associated with some kind of plastic procedure to lower the risk of bad cosmetic results (representing 25% of the CS associated with plastic surgery), we confirmed the value of the mixed oncologic and plastic approach. The esthetic results observed in this series are better than those observed in another series previously published at the Gustave-Roussy Institute (IGR) - good results: 72% (IEO) vs 50% (IGR), and bad results: 6% (IEO) vs 20% (IGR). Statistically such comparison can be criticised, specially because of the short follow-up of the Milan series. However, the difference is rather important if we consider that the series of Milan was a selection of cases with poor esthetic expectation (25% of all the CS performed during the same period), while the series of Paris did not select the patients in what concerns the risk of poor esthetic result.

Original languageFrench
Pages (from-to)168-176
Number of pages9
JournalAnnales de Chirurgie Plastique et Esthetique
Volume42
Issue number2
Publication statusPublished - 1997

Fingerprint

Plastic Surgery
Esthetics
Mammaplasty
Breast Neoplasms
Breast
Therapeutics
Paris
Cosmetics
Plastics
Cicatrix
Neoplasms

Keywords

  • Breast cancer
  • Breast reconstruction
  • Mammoplasties

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

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title = "La place de la chirurgie plastique dans le traitement conservateur du cancer du sein",
abstract = "Conservative surgery (CS) is widely accepted today as the treatment of choice for 60 to 80{\%} of the primary breast cancer. Esthetic results of CS are not good in all the cases and improvement can be obtained thanks to the remodelling of the breast after tumorectomy. The scar should be selected according to the location of the tumor; the glandular tissue should be reshaped using local glandular flaps or following the principles of the reduction mammaplasties. Tumorectomy located in the upper part of the gland can be reshaped with an inferior pedicle type of mammoplasty. Defect located in the inferior part of the gland can be reconstructed with a superior pedicle mammoplasty. These sophisticated tumorectomies are providing good esthetic results on the reconstructed breast but require commonly a symmetry procedure on the contralateral breast. Such contralateral reduction allows a better exploration of the opposite breast and histological examination of the reduction specimen. In a series of 76 CS performed at the European Institute of Oncology (IEO), which were associated with some kind of plastic procedure to lower the risk of bad cosmetic results (representing 25{\%} of the CS associated with plastic surgery), we confirmed the value of the mixed oncologic and plastic approach. The esthetic results observed in this series are better than those observed in another series previously published at the Gustave-Roussy Institute (IGR) - good results: 72{\%} (IEO) vs 50{\%} (IGR), and bad results: 6{\%} (IEO) vs 20{\%} (IGR). Statistically such comparison can be criticised, specially because of the short follow-up of the Milan series. However, the difference is rather important if we consider that the series of Milan was a selection of cases with poor esthetic expectation (25{\%} of all the CS performed during the same period), while the series of Paris did not select the patients in what concerns the risk of poor esthetic result.",
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