الفهرس | Only 14 pages are availabe for public view |
Abstract There has been major progress in breast cancer surgery over the past few decades. Special attention to cosmetic results and the quality of life of the patients are of major concern. Disfiguring and mutilating surgical procedures can no longer be justified for most patients. In this way, oncoplastic surgery of the breast has emerged. It combines oncologic and plastic surgery techniques in order to improve the final aesthetic outcomes. It includes appropriate oncologic surgery, immediate reconstruction using the full range of all available plastic surgery techniques, and immediate correction of contralateral breast asymmetry, whenever indicated. Oncoplastic techniques for breast conserving surgery includes two main categories either volume displacement techniques utilizing local tissue rearrangement and mastopexy, or volume replacement techniques utilizing autologous tissue flaps. Immediate breast reconstruction with volume displacement and replacement techniques has better oncologic results in breast-conserving surgery in terms of margins, lower index of re-excisions, better local control of disease, and positive results regarding radiotherapy planning, particularly for the group of patients with gigantomastias. It is clear that the combination of plastic surgery techniques and breast conserving surgery do not compromise clear excision margins or the long-term oncologic results. Moreover, immediate breast reconstruction has better aesthetic outcomes than delayed breast reconstruction after conservative surgery and mastectomies. Patients with pronounced asymmetry after breast cancer surgery are more likely to feel significantly stigmatized. They have more psychosocial problems due to loss of their femininity, more depressive symptoms, and, consequently, impaired quality of life. Oncoplastic surgery offers a solution for these problems by complete eradication of the tumor with reassuring oncologic outcome to the patient, combined with aesthetic satisfaction due to early breast reconstruction and asymmetry correction. |