Versatility of therapeutic reduction mammoplasty in oncoplastic breast conserving surgery

Oncoplastic breast conserving surgery is the gold standard approach for the surgical treatment of early breast cancer. There is a well defined technique named “therapeutic mammoplasty” which is characterized for using a reduction mammaplasty technique to treat breast cancer conservatively. In our current practice, “therapeutic mammoplasty” or therapeutic reduction mammaplasty is our favorite oncoplastic breast conserving approach which it used in almost half of our patients. This technique is very versatile allows us the resection of tumors located in all breast quadrants of patients with moderate-to large-sized breasts. We describe a series of 57 patients who were treated using a therapeutic reduction mammaplasty. All surgical procedures were carried out by one comprehensive breast surgeon who planned and designed the surgery performing both oncologic and reconstructive procedures. Surgical margins were insufficient in eight patients (14%). Nine patients (15.8%) had a complication in early postoperative period and in one of them adjuvant radiotherapy was delayed four months due to a wound dehiscence

Is there Enough Justification for Questioning Body Mass Index (BMI) as Exclusion Criteria of Reduction Mammoplasty in the Surgical Treatment of Symptomatic Macromastia?

Background: Despite the fact that reduction mammaplasty is an effective and efficient treatment to symptomatic macromastia, frequently, women demanding this treatment are accepted or not depending on body mass index criteria. The aim of this work was to compare changes of quality of life on obese and no-obese women who undergoing breast reduction mammaplasty. Methods: A prospective study was performed on 56 consecutive women undergoing bilateral reduction mammaplasty for symptomatic macromastia, 21 of them had a BMI lower than 30 (No-obese group) and 35 with 30 or higher BMI (Obese group). Short Form SF-36 quality of life questionnaires were answered at interviews a week before the surgery and six months after. To evaluate the change of quality of life we used “effect size”. Results: Preoperative SF36 scores did not make differences between both groups. Six months after surgery only postoperative physical score of no-obese patients was significantly higher than obese one (52.11 vs 48.47, p>0.05). Both groups increased clearly their quality of life showing an increment of all SF36 domains with an effect size ranged from 0.53 to 2.07. More than seventy percent of obese women improved their scores exceeding means of preoperative scores. Conclusion: According to our results and the fact that the main goal of the breast reduction is ameliorate the quality of life there is no justification for exclusion obese patients with BMI >30 who suffer from symptomatic macromastia from reduction mammaplasty

Comparison of Conventional vs. Oncoplastic Breast-Conserving Surgery in a Breast Unit with Oncoplastic Training

Purpose: Oncoplastic Breast Conserving Surgery (OBCS) has been tested in oncological terms demonstrating that it is as effective as Standard Lumpectomy (SL) nowadays; Patients-Reported Outcomes (PRO) have become a relevant way to assess breast cancer treatment. The aim of this work was to compare OBCS with SL using a PRO measurement, BREAST-Q Breast Conserving Therapy (BCT) module. Methods: One hundred and sixty-five patients with early primary breast cancer treated with BCT were questioned using BREAST-Q Version 2.0 BCT Module, postoperative scales, in Spanish, after radiotherapy treatment was administered. The patients filled in the questionnaire in a paper-andpencil format at our breast unit. The sample size was estimated to observe differences of 7 points in the satisfaction with breast domain (postoperative scale) between both approaches. This difference is slightly higher than 10% of the median of satisfaction with breast domain reported in published studies. An analysis was done to compare statistics. Results: SL was used in 108 patients and OBCS in 57. Patients treated with OCBS had a larger radiological lesion than patients treated with SL (median 20 mm vs. 15 mm) corresponding with a higher pathological tumor (17 mm vs. 13 mm). The time from the radiotherapy end date to when the questionnaire was filled in was longer in those patients treated with OBCS (mean 8 vs. 15.5 months). No significant statistical differences were found in the BREAST-Q postoperative domain scores between both approaches. Conclusion: The quality of life and the satisfaction with the oncoplastic breast conserving approach or the standard lumpectomy evaluated by the BREAST-Q were similar in our breast unit

Centrally located breast carcinomas treated with central quadrantectomy and immediate nipple-areola reconstruction: a cohort study

Background: Mastectomy has often been cited as the favoured option for centrally located breast tumours because lumpectomies or quadrantectomies that remove the nipple-areola complex often result in poor cosmesis. Currently, breast-conserving treatment is a preferred treatment for centrally located breast tumours, but this approach requires oncoplastic breast technique to avoid aesthetic sequels. This article describes the use of breast reduction techniques with immediate nipple-areola complex reconstruction (utilised to treat breast cancer) for centrally sited breast tumours PATIENTS: Ten patients suffering from a centrally located breast carcinoma were treated at our breast unit over a period of 16 years (2006-2022). Oncologic and patient-reported outcomes were updated revising electronic reports and surveying with BREAST-Q module Breast conserving therapy (version 2, Spanish) postoperative scales. Results: Excision margins were complete in all cases. There have been no postoperative complications, all patients are alive and no cases of recurrence after 84.8 months of mean follow-up. Patients score the domain satisfaction with breast: mean 61.7 (Standard deviation 12.5) out of 100. Conclusions: Breast reduction mammaplasty with immediate nipple-areola complex reconstruction allows surgeons to carry out a central quadrantectomy to treat centrally located breast carcinoma with good oncologic and cosmetic outcom

Delaying surgery for patients with a previous SARS-CoV-2 infection

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