الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
SUMMARY AND UMMARY AND UMMARY AND UMMARY AND UMMARY AND CONCLUSION ONCLUSION ONCLUSIONONCLUSION
ide-spread screening mammography and technological developments have led to a rapid increase in the diagnosis of small, nonpalpable breast cancer.
Early diagnosis can partially be achieved through rapid access referral, accurate triple assessment and multidisciplinary management of potential breast cancer patients. All patients presenting with breast symptoms should undergo triple assessment, this involves history taking and examination, followed by breast imaging and pathological assessment.
Breast conservation surgery with adjuvant radiotherapy has become widely accepted as a treatment modality for early stage breast cancer.
Breast conservation involves resection of the primary breast cancer with a margin of normal appearing breast tissue, adjuvant radiation therapy, and assessment of regional lymph node status.
The term tumorectomy (lumpectomy) refers to removal of the tumor with a margin of surrounding breast tissue (approximately 2 cm). Margins are grossly free of tumor at the macroscopic level but may be involved at the microscopic level. Wide local excision removes a greater volume of surrounding tissue and aims for a clearance of 2–3 cm. Quadrantectomy is a
W
Summary and Conclusion
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form of wide local excision in which a wide segment (a ‘quadrant’) of tissue is resected that includes 1–3 cm of surrounding breast tissue together with skin and pectoral fascia. The distinction between these surgical approaches is often unclear, and sometimes tumorectomy and quadrantectomy are reported as wide local excision.
Oncoplastic surgery defines the appropriate adequate surgery to extirpate a cancer in the breast combined with partial or total reconstruction as well as immediate or delayed reconstruction with access to a full range of techniques to correct excision defects.
Numerous oncoplastic procedures are available for reconstructing mastectomy defects. Those procedures may be held at the same time, weeks after or months to years afterwards, so called immediate, delayed-immediate or delayed reconstruction, respectively. Each timing option has advantages and disadvantages.
When considering a patient for an oncoplastic breast conserving procedure, we should consider volume of tissue to be excised, tumor location, breast size and glandular density and Patient related risk factors.
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Oncoplastic reconstruction techniques can be broadly categorized into volume displacement and volume replacement techniques.
Volume displacement involves the principle of mobilizing local glandular or dermoglandular flaps and transposing them into the resection defect. This employs predominantly mammoplasty techniques. The result is a net loss of breast volume from which arises the potential requirement for contralateral symmetrisation procedures.
The most widely used volume displacement techniques:
Local tissue rearrangement,
Benelli’s ‘round block’ technique
The omega-plasty, or ‘batwing’ mastopexy),
Superior and inferior pedicle reduction mammoplasty,
S-shape mammoplastyand
The B-Mammoplasty
V Mammoplasty
J Mammoplasty
The Grisotti Technique for Reconstruction of Central Quadrantectomy Defects.