الفهرس 
Aesthetic Anatomy of The BreastOnly 14 pages are availabe for public view
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Abstract
The World Health Organization has ranked breast cancer as the most common type of cancer among women world-wide. The incidence rates of breast cancer vary worldwide, with higher rates in North America, Northern and Western Europe; intermediate rates in South America and Southern Europe; and lower rates in Africa and Asia1.
Breast cancer accounts for 38% of all new cancer cases among women living in Egypt. The age standardized rate (ASR) for breast cancer incidence in Egypt is 37.3 compared to 76 in the United States. Although incidence remains significantly lower than in highly developed countries, rates are steadily increasing 2.
Since the Early Breast Cancer Trialists’ Collaborative Group established the equivalency of mastectomy and breast conserving therapy in 1985, breast conserving surgery has remained the optimal surgical treatment for the breast cancer patient. The goals of breast conserving surgery are the removal of breast cancer with an adequate surgical margin and maintenance of a breast that is cosmetically acceptable to the patient.
Mastectomy with or without breast reconstruction is the treatment of choice when tumor resection and cosmesis is unattainable. Given the understandable desire to preserve a sense of wholeness, it is not surprising that many women consider mastectomy to be an unacceptable cosmetic alternative to breast conserving surgery 3Other trials are now well understood and accepted that prove the importance of combining surgery with adjuvant radiation therapy to lower local-regional recurrence and systemic adjuvant treatment to reduce distant metastatic disease and improve survival.
Through these many studies, a methodological approach was developed to improve multidisciplinary cancer therapy to evaluate, treat, and study women with breast cancer. This scientific approach has become an accepted cornerstone for obtaining optimal patient outcomes and is similarly relevant to the introduction of new oncoplastic surgical techniques 4.
The goal of optimizing the cosmetic and oncologic outcomes of BCS has been addressed in recent years by the emergence of the field of oncoplastic surgery. Originally defined as an assortment of volume replacement techniques performed by plastic surgeons to replace all or part of the resected breast volume with myocutaneous tissue flaps, the definition of oncoplastic surgery has more recently been expanded to include a wide range of volume displacement or volume redistribution procedures performed by breast surgeons and general surgeons to optimize breast shape and breast volume following breast cancer surgery 5
Also included in the definition of “oncoplasty” is the surgical correction of breast asymmetry achieved by reducing or reconstructing the contralateral breast. The emergence of oncoplastic surgery reflects a growing appreciation for the importance of breast cosmesis and the willingness of many surgeons to obtain advanced training to improve cosmetic outcomes for their patients 5
A recent study has demonstrated that oncoplastic approaches add to the oncologic safety of breast-conserving treatment, because a larger volume of breast tissue can be excised and more widely negative surgical margins can be obtained 6.
Oncoplastic techniques are especially indicated for large tumors, for which standard breast-conserving approaches have a high probability of leaving positive margins associated with heightened local recurrence risk and/or creating unacceptable deformity of the breast7.
Oncoplastic surgery requires a multidisciplinary approach to breast cancer care characterized by close collaboration between the breast surgeon, radiologist, radiation oncologist, and, when appropriate, plastic surgeon, medical oncologist, genetic counselor, and psychologist all working together to help the patient achieve the best possible surgical & psychological outcome8