Study To Evaluate The Value Of Obliteration Of The Cavity During Breast Conservative Surgery For Breast Cancer

Abstract

Breast-conserving treatment (BCT) has become the standard treatment in early-stage breast cancers, Its goal is to provide a treatment as effective as mastectomy, with the added benefit of a preserved breast. However, it is sometimes difficult to achieve good cosmetic results, particularly in patients with large, ill-defined, or poorly situated tumors, for which clear margins are difficult to achieve without leaving deformed and asymmetrical breasts.

Oncoplastic breast conserving surgery (oBCS), which combines a plastic surgical procedure with BCT, is a new surgical approach that extends the role of BCS in situations previously considered unsuitable for conservation (large tumour size, central and lower pole tumour location or multifocality), and allows wide excisions as well as has the potential to improve the aesthetic outcome of BCS and prevents breast deformities by immediate reconstruction of large resection defects. The quadrantectomy approach or the segmental parenchymal wide excision including the overlying skin were the basis for OP. Plastic surgery techniques were transposed into BCS as a refinement in 1980s in France by Jean-Yves Petit (Institut Goustave-Roussy), Jean-Yves Bobin (Centre Le´on-Be´ rard) and Michel Abbes (Centre Lacassagne). Some years after, the OP concept was then originally coined by Werner Audrescht in German, and nowadays had a major diffusion with the publication of the classic paper from Krishna Clough and colleagues in 2003.

The original focus of OP was to maintain quality of life of patients undergoing oncological treatments, since majority of them are expected to enjoy long-term survival. It can be more effective from the aesthetic-functional point of view than traditional BCS techniques, without compromising local control and survival.

In conclusion, oncoplastic surgery gives a new tool for the treatment of breast cancer as much larger volume of breast tissue can be excised, and wider surgical margins can be achieved especially for larger tumors with better cosmetic outcome, in which a standard resection can lead to poor cosmetic results and tumor-involved surgical margins.

Since improving the accuracy of tumor removal while reducing disfigurement in women with breast tumors have been a goal and as oncoplastic surgery extending the indications of BCT by allowing breast conservation and good cosmesis despite wide excisions, so Oncoplastic breast conservation surgery should be offered to all patients undergoing wide local excision of breast tumor as Patient satisfaction with BCS and oncoplasty is very high.