Simple reconstructive techniques for conservative breast cancer surgery

Published Date: 25th April 2017

Publication Authors: Jois RHS,

Background

Patients undergoing breast conservation surgery (BCS) for cancer may benefit with the defect reconstruction using simple techniques to obtain optimal cosmetic & oncological outcome.

Aim

To determine feasibility simple oncoplastic level 2 reconstruction as a day case.

Material and Methods

A prospective series of patients eligible for BCS & likely to have poor cosmetic result were considered for oncoplastic reconstruction techniques. All patients had triple assessment for cancer diagnosis, preoperative counselling & consenting two weeks prior to surgery. Markings performed on the day of surgery. The oncological margin clearance & need for further surgery were discussed at MDT after histopathology. The cosmetic outcomes assessed at periodic intervals.

Results

15 pts underwent type 2 oncoplastic surgery following BCS during 2014-15. Mean age 58 years. Median tumour size 25 (0-48) mm. Median specimen weight 48 (16-129) grams. Median specimen volume 107 (28-267) cm 3. Negative pathological margin 14/15 (93%) pts. Median hospital stay 0 days. 4 (25%) pts had surgery after neoadjuvant therapy. 5/15 (33%) tumours were grade III cancer. The oncoplastic approaches used; glandular rotational flaps 8, nipple recentralisation 2, perforator flaps 5. Median operating time 98 mins. Redo breast surgery 1/15 (6%). Complications; marginal flap necrosis & delayed wound healing 1, total flap failure 1. Cosmetic outcome very good and excellent 12. No drain used in this cohort.

Conclusion

Simple oncoplastic procedures to fill defects of BCS is feasible as a day case. A good oncological clearance (93%) and cosmetic outcome can be obtained when right patient is chosen.

Jois, R; Audisio, R. (2016). Simple reconstructive techniques for conservative breast cancer surgery – A DGH experience . European Journal of Surgical Oncology. 42 (5), S29

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