Indications and Selection Criteria of Patients Undergoing Oncoplastic Breast Surgery

Abstract

The aim of this study is to: (1) Reviewthe indications and selection criteria for oncoplastic surgery (2) Explain how the correlation of the tumor type, size and grade to the breast size and shape influence the surgeon decision of the type of oncoplastic procedure performed. Breast cancer is the most common neoplasm in women accounting for about 26% of all cancer cases diagnosed annually. It is over all the second leading cause of cancer death. However breast cancer is the leading cause of cancer death in women below 65 years. 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 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. In addition to being equivalent to mastectomy in terms of oncologic safety. BCT appear to offer advantages over mastectomy with regard to quality of life and aesthetic outcomes. BCT allows for preservation of breast shape and skin as well as preservation of sensation and provides an overall psychological advantage associated with breast preservation. Oncoplastic surgery defines the appropriate adequate surgery to extirpate a cancer in the breast to achieve locoregional control 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, contralateral breast symmetrization and reconstruction of the nipple - areola complex (NAC), when needed. Contraindications for oncoplastic surgery are generally defined by contraindications for BCT. These include multicentric disease, progressive disease after neoadjuvant therapy and patients’ wishes. Finally: Showing the different and recent advances in either immediate or delayed Breast Reconstruction following mastectomy will reach our main goal which is to adequately excise the tumour as well as restoring symmetry, or volume, natural projection and reconstruction of nipple and areola. Trying to restore the breast which is a potent symbol of feminity which greatly import the emotional, psychological and social status of the patient. Keywords: BCS: Breast conserving surgery; BCT: Breast conserving therapy; OPS :Oncoplastic breast surgery