الفهرس 
Background
IntroductionOnly 14 pages are availabe for public view
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Abstract
Recently, increasing attention has been focused on oncoplastic procedures since the immediate application of plastic breast surgery techniques provides a wider local excision while still achieving the goals of a better breast shape and symmetry.
In fact, the modern oncoplastic breast surgery combines principles of oncologic and plastic surgery techniques to obtain an oncologically sound and aesthetically pleasing results. Thus, by means of tailored techniques the surgeon ensures that the oncologic principles are not jeopardized while meeting the needs of the patients from an aesthetic point of view hence the name of oncoplastic breast surgery.
The primary advantage of oncoplastic breast surgery is the feasibility to get wider free margins and the improved cosmetic outcome. Not all patients with breast cancer may need oncoplastic surgery. Eligible patients usually who have an unfavorable tumor/breast size ratio, as well as tumor locations that would result in large visible scars and deep breast defects if conventional techniques of BCS were to be performed alone.
Therapeutic mammoplasty (TM) is a set of volume displacement oncoplastic surgical techniques that involve glandular remodeling using various reduction mammoplasty techniques as well as other parenchymal displacement and reshaping procedures.
Oncologically, Therapeutic mammoplasty allows for the excision of the tumor with wide safety margins and thus more oncological safety, also the symmetrization surgeries for the contralateral breast allow for histological screening and in some extent reduce the risk for contralateral breast cancer.
In this study, which was conducted on 46 patients at Assiut university hospital in general surgery department from October 2015 to October 2018 ; who were diagnosed as early breast cancer, we used 5 different techniques each of which was tailored to its suitable patient according to the tumor site, breast cup size , Tumor/breast ratio and degree of breast ptosis. There is no ideal technique for all patients but there is a best proper technique for each patient alone.
In this study, after a mean follow up of 37 months, local recurrence rate was (4.35%), distant recurrence rate was (4.35%) and the intra-operative re- excision rate was (4.3%), so we believe that Therapeutic mammoplasty is an oncologically safe approach in well selected patients with early breast cancer, however a longer follow up duration is needed.
The aesthetic outcome was “good” according to patient degree of satisfaction and “excellent” according to the surgeon and nurse evaluation.
We have encountered minor complications as wound infection in (6.42%) of patients and wound dehiscence in (4.35%). Breast seroma was developed in (10.87%) and fat necrosis in (5.52%) and loss on NAC sensation in (10.87%).