Oncoplastic Surgeries for Central Breast Tumors

Abstract

B reast cancer is the most common cancer among women and is the second leading cause of cancer deaths. The management of patients with breast cancer has evolved over the past couple of decades as a result of a better understanding of the biologic behaviour of breast cancer, advances in adjuvant chemotherapy and hormonal therapy, advances in radiographic detection of early-stage breast cancer, and the implementation of breast conservation therapy and sentinel lymph node biopsy. Routine screening mammography and increased breast cancer awareness are primarily responsible for the trend towards earlier diagnosis. Although radical and modified radical mastectomies have been the mainstay treatment for early-stage breast cancer for decades, breast-conserving therapy has recently become the preferred method of treatment for appropriate patients with early-stage breast cancer. Breast reconstruction has become an integral aspect of breast cancer management. The timing of breast reconstruction after mastectomy involves many factors that are important when choosing between immediate and delayed reconstruction. Immediate reconstruction has positive psychological implications on patients by reducing the physical mutilation in oppose to delayed reconstruction. In addition, practice patterns have gradually trended towards more immediate reconstructions for non-irradiated patients owing to superior aesthetic outcomes, more facilitating recoveries, and the ability to maintain an equivalent oncologic outcome. The primary goal of breast reconstruction is to create a long lasting, naturally appearing breast after the treatment of breast cancer. This goal should be achieved with the least possible morbidity at the donor site. Recent techniques in breast reconstruction are broadly divided into autologous tissue reconstruction, non-autologous reconstruction or a combination of both. Autologous tissue breast reconstruction can generally be grouped into three main categories: local tissue rearrangement with composite breast flaps, reduction mammaplasty, and transfer of remote tissue in the form of a vascularised regional or distant flap. Nipple- areola complex reconstruction is an integral component of breast reconstruction which transforms the reconstructed breast mound into a more natural and pleasing breast It is typically by the use of local dermoglandular flaps as a composite free nipple graft. Areolar tattooing and secondary procedures to improve nipple height can also be done at a later date.