Oncoplastic Breast Surgery
Online ISSN : 2432-4647
ISSN-L : 2432-4647
Review Articles
Oncoplastic Breast-conserving Surgery - Bridging the Gap between Mastectomy and Breast-conserving Surgery
Hiroshi FujimotoTakeshi NagashimaMasayuki Ohtsuka
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2018 Volume 3 Issue 3-4 Pages 59-68

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Abstract

Oncoplastic breast-conserving surgery enables the excision of large tumors with satisfactory surgical margins while maintaining cosmesis by incorporating partial resection with immediate reconstruction. It is categorized into two different methods: 1) the volume displacement technique, which combines resection with adjacent breast tissue rearrangement, and 2) the volume replacement technique, which replaces excised breast tissue with a local or distant flap. The former is suitable for patients with larger breasts who occasionally require contralateral surgery, whereas the latter is applied for patients with smaller breasts who may require an extra-mammary incision. Immediate partial breast reconstruction may lead to fewer complications and better cosmetic results. However, it leaves the risk of positive margins and re-excision. To reduce the positive margin, it is necessary to select appropriate candidates based on the careful evaluation of breast images and tumor characteristics. As tissue rearrangement may make it difficult to identify the tumor bed, marking with a metal clip immediately after tumor resection is recommended to optimize boost irradiation. Expertise in both oncology and plastic surgery is necessary for success, and the training system needs to be improved.

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© 2018 Japan Oncoplastic Breast Surgery Society
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