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Ferrucci M, Milardi F, Passeri D, Mpungu LF, Francavilla A, Cagol M, Saibene T, Michieletto S, Toffanin M, Del Bianco P, Grossi U, Marchet A. Intraoperative Ultrasound-Guided Conserving Surgery for Breast Cancer: No More Time for Blind Surgery. Ann Surg Oncol 2023; 30:6201-6214. [PMID: 37606837 DOI: 10.1245/s10434-023-13900-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 06/23/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Breast-conserving surgery (BCS) still remains a blind surgery despite all available tumor localization methods. Intraoperative ultrasound (IOUS) allows real-time visualization during all resection phases. METHODS This was a prospective observational cohort study conducted at the Veneto Institute of Oncology between January 2021 and June 2022. Patients with ductal carcinoma in situ, T1-2 invasive cancer, or post-neoadjuvant tumors, suitable for BCS, were recruited. All breast cancer lesion types were included, i.e. solid palpable, solid non-palpable, non-solid non-palpable, and post-neoadjuvant treatment residual lesions. Eligible participants were randomly assigned to either IOUS or traditional surgery (TS) in a 1:1 ratio. The main outcomes were surgical margin involvement, reoperation rate, closest margin width, main specimen and cavity shaving margin volumes, excess healthy tissue removal, and calculated resection ratio (CRR). RESULTS Overall, 160 patients were enrolled: 80 patients were allocated to the TS group and 80 to the IOUS group. IOUS significantly reduced specimen volumes (16.8 cm3 [10.5-28.9] vs. 24.3 cm3 [15.0-41.3]; p = 0.015), with wider closest resection margin width (2.0 mm [1.0-4.0] vs. 1.0 mm [0.5-2.0] after TS; p < 0.001). Tumor volume to specimen volume ratio was significantly higher after IOUS (4.7% [2.5-9.1] vs. 2.9% [0.8-5.2]; p < 0.001). IOUS yielded significantly better CRR (84.5% [46-120.8] vs. 114% [81.8-193.2] after TS; p < 0.001), lower involved margin rate (2.5 vs. 15%; p = 0.009) and reduced re-excision rate (2.5 vs. 12.5%; p = 0.032). CONCLUSIONS IOUS allows real-time resection margin visualization and continuous control during BCS. It showed clear superiority over TS in both oncological and surgical outcomes for all breast cancer lesion types. These results disfavor the paradigm of blind breast surgery.
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Affiliation(s)
- Massimo Ferrucci
- Breast Surgery Unit, Veneto Institute of Oncology IOV, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy.
| | - Francesco Milardi
- General Surgery, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Daniele Passeri
- General Surgery, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | | | - Andrea Francavilla
- Unit of Biostatistics, Epidemiology and Public Health, Department of CardiacThoracic Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Matteo Cagol
- Breast Surgery Unit, Veneto Institute of Oncology IOV, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy
| | - Tania Saibene
- Breast Surgery Unit, Veneto Institute of Oncology IOV, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy
| | - Silvia Michieletto
- Breast Surgery Unit, Veneto Institute of Oncology IOV, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy
| | - Mariacristina Toffanin
- Breast Surgery Unit, Veneto Institute of Oncology IOV, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy
| | - Paola Del Bianco
- Clinical Trials and Biostatistics, Veneto Institute of Oncology IOV, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy
| | - Ugo Grossi
- General Surgery, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Alberto Marchet
- Breast Surgery Unit, Veneto Institute of Oncology IOV, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy
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Faulkner HR, Losken A. Modern Approaches to Oncoplastic Surgical Treatment. Clin Plast Surg 2023; 50:211-221. [PMID: 36813399 DOI: 10.1016/j.cps.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Partial breast reconstruction using oncoplastic techniques is performed at the time of lumpectomy and includes volume replacement techniques such as flaps and volume displacement techniques such as reduction and mastopexy. These techniques are used to preserve breast shape, contour, size, symmetry, inframammary fold position, and position of the nipple-areolar complex. Newer techniques such as auto-augmentation flaps and perforator flaps continue to broaden options and newer radiation therapy protocols will hopefully reduce side effects. Options for the oncoplastic approach now include higher risk patients as there is a larger repository of data on the safety and efficacy of this technique.
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Affiliation(s)
- Heather R Faulkner
- Emory Division of Plastic and Reconstructive Surgery, 550 Peachtree Street Northeast, Suite 9000, Atlanta GA 30308, USA
| | - Albert Losken
- Emory Division of Plastic and Reconstructive Surgery, 550 Peachtree Street Northeast, Suite 9000, Atlanta GA 30308, USA.
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The Beneficial Impact of Intraoperative Ultrasound on Resection Margin Status during Breast Conserving Surgery. Int J Surg Oncol 2022; 2022:2268821. [DOI: 10.1155/2022/2268821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 11/05/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022] Open
Abstract
Background. Surgical resection with clear surgical cut margins is the mainstay of managing malignant breast neoplasms. Multiple techniques have been suggested to enhance resection status during breast-conserving surgery (BCS), including intraoperative ultrasonography (IOUS). Herein, we conducted the current investigation to reveal the benefit of IOUS on the achievement of R0 resection. Patients and Methods. This retrospective investigation included 140 patients who underwent BCS. They were divided into two groups: the IOUS group (40 cases) and the control group (100 cases). Our primary objective was to determine the free resection margin status (R0). Results. Both study groups expressed statistically comparable demographic and clinical data. Additionally, histopathological examination revealed no significant difference between the two groups regarding the tumor type, stage, or grade. Nonetheless, the R0 resection margin was more frequently encountered in association with IOUS application (97.5% compared to 79% in the control group), and that difference was statistically significant (
). Conclusion. The application of IOUS has a significant beneficial impact on the outcomes of BCS. It is associated with a marked decline in positive resection margins, and its application should be encouraged in the breast oncological practice.
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Wang Q, Li Z, Huang X, Fu X, Li Q, Li H. Step-by-Step Method Combined with Simulation-Enhanced Learner Outcomes in Minimally Invasive Breast Surgery Education. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2022; 13:1051-1060. [PMID: 36120393 PMCID: PMC9481279 DOI: 10.2147/amep.s367304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 08/31/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Traditional standardized training in ultrasound-guided minimally invasive breast surgery (UMIBS) focused on lecture-based learning (LBL) resulted in students' insufficient analysis, limited spatial visual conversion ability, and poor practical application. This study examined the effects of the step-by-step (SBS) method combined with a simulation model in UMIBS education. SUBJECTS AND METHODS A total of 84 residents participated in this study. The residents were divided into the SBS group (experience group, n=42) and the LBL group (control group, n=42), and the same teacher taught the two groups to ensure a comparable result. Based on the pork simulation model, two experts evaluated student performance scores, and the total time taken by each student was also counted. The participants were surveyed with 7 questions after the training, and each answer was assigned a score of 1, 2 or 3 to compare the participants' satisfaction. RESULTS The average value of the surgical skills for SBS group were significantly higher than LBS group, which was 82.8±4.4 and 72.7±4.0 (t=4.27, P<0.001), the time spend of neoplasm localization by the experience group was significantly less than the control group, which was 17.9±1.6 and 20.9±1.2 secs, (t=1.58, P<0.001), and there were significant differences in puncture accuracy and excision integrity between the two groups (P<0.05). In addition, the results of the questionnaire survey showed that learning interest, surgical ability and satisfaction were better in the SBS group than in the LBS group (P<0.05), and there were no significant differences in clinical thinking and learning pressure between the two groups. CONCLUSION The SBS teaching method may help to improve the surgical skills and learning interest, as well as reduce adverse reactions and cultivate clinical thinking of the students in UMIBS training. Future studies could consider multicenter clinical research to further confirm the practicality of this teaching method and reduce the risk of deviation.
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Affiliation(s)
- Qinbo Wang
- Department of Breast Surgery, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China
- Department of Pharmacy, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China
- Department of Graceland Medical Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Zongyan Li
- Department of Breast Surgery, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Xiaojia Huang
- Department of Breast Surgery, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Xiaoyan Fu
- Department of Breast Surgery, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Qian Li
- Department of Breast Surgery, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Haiyan Li
- Department of Breast Surgery, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China
- Department of Graceland Medical Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China
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The Tumor Plastic Surgery Technology versus Traditional Repair Technology on the Repair of Large-Area Skin Defects after Maxillofacial Tumor Resection: A Randomized Controlled Trial. JOURNAL OF ONCOLOGY 2022; 2022:3004695. [PMID: 35664564 PMCID: PMC9162858 DOI: 10.1155/2022/3004695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 04/12/2022] [Accepted: 04/19/2022] [Indexed: 11/30/2022]
Abstract
Objective To explore the effect of tumor plastic surgery on the repair of large-area skin defects after maxillofacial tumor resection. Methods 90 patients undergoing maxillofacial tumor resection in our hospital from March 2019 to March 2020 were selected and randomized 1 : 1 to receive either tumor plastic surgery (experimental group) or traditional repair (control group). The clinical efficacy and facial cosmetic improvement of the two groups were compared. The Patient and Observer Scar Assessment Scale (POSAS) was used to evaluate the surgical outcomes of the two groups, the Profile of Mood States (POMS) was used to evaluate the patients' psychological status, and the Generic Quality of Life Inventory-74 (GQOLI-74) was used to assess the quality of life of patients. Results Total clinical effective rate of the experimental group was significantly higher than that of the control group (p < 0.001). A higher excellent rate of facial cosmetic improvement was observed in the experimental group versus the control group (p < 0.001). Significantly lower POSAS scores of the experimental group than the control group were observed (p < 0.001). The POMS scores of the experimental group after treatment were lower than those of the control group (p < 0.001). Tumor plastic surgery resulted in a remarkably higher GQOLI-74 score in the patients versus traditional repair (p < 0.001). Conclusion Tumor plastic surgery is a promising alternative for patients undergoing maxillofacial tumor resection. It can effectively promote the recovery of facial morphology and physiological function of patients, with high clinical efficacy, so it merits promotion and application.
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Gubarkova EV, Sovetsky AA, Vorontsov DA, Buday PA, Sirotkina MA, Plekhanov AA, Kuznetsov SS, Matveyev AL, Matveev LA, Gamayunov SV, Vorontsov AY, Zaitsev VY, Gladkova ND. Compression optical coherence elastography versus strain ultrasound elastography for breast cancer detection and differentiation: pilot study. BIOMEDICAL OPTICS EXPRESS 2022; 13:2859-2881. [PMID: 35774307 PMCID: PMC9203088 DOI: 10.1364/boe.451059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/01/2022] [Accepted: 04/05/2022] [Indexed: 05/20/2023]
Abstract
The aims of this study are (i) to compare ultrasound strain elastography (US-SE) and compression optical coherence elastography (C-OCE) in characterization of elastically linear phantoms, (ii) to evaluate factors that can cause discrepancy between the results of the two elastographic techniques in application to real tissues, and (iii) to compare the results of US-SE and C-OCE in the differentiation of benign and malignant breast lesions. On 22 patients, we first used standard US-SE for in vivo assessment of breast cancer before and then after the lesion excision C-OCE was applied for intraoperative visualization of margins of the tumors and assessment of their type/grade using fresh lumpectomy specimens. For verification, the tumor grades and subtypes were determined histologically. We show that in comparison to US-SE, quantitative C-OCE has novel capabilities due to its ability to locally control stress applied to the tissue and obtain local stress-strain curves. For US-SE, we demonstrate examples of malignant tumors that were erroneously classified as benign and vice versa. For C-OCE, all lesions are correctly classified in agreement with the histology. The revealed discrepancies between the strain ratio given by US-SE and ratio of tangent Young's moduli obtained for the same samples by C-OCE are explained. Overall, C-OCE enables significantly improved specificity in breast lesion differentiation and ability to precisely visualize margins of malignant tumors compared. Such results confirm high potential of C-OCE as a high-speed and accurate method for intraoperative assessment of breast tumors and detection of their margins.
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Affiliation(s)
| | | | | | - Pavel A. Buday
- Nizhny Novgorod Regional Oncologic Hospital, Nizhny Novgorod, Russia
| | | | | | | | | | - Lev A. Matveev
- Institute of Applied Physics RAS, Nizhny Novgorod, Russia
| | | | | | - Vladimir Y. Zaitsev
- Institute of Applied Physics RAS, Nizhny Novgorod, Russia
- Equally contributed
| | - Natalia D. Gladkova
- Privolzhsky Research Medical University, Nizhny Novgorod, Russia
- Equally contributed
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Li W, Li X. Development of intraoperative assessment of margins in breast conserving surgery: a narrative review. Gland Surg 2022; 11:258-269. [PMID: 35242687 PMCID: PMC8825505 DOI: 10.21037/gs-21-652] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 11/17/2021] [Indexed: 07/28/2023]
Abstract
OBJECTIVE We intend to provide an informative and up-to-date summary on the topic of intraoperative assessment of margins in breast conserving surgery (BCS). Conventional methods as well as cutting-edge technologies are analyzed for their advantages and limitations in the hope that clinicians can turn to this for reference. This review can also offer guidance for technicians in the future design of intraoperative margin assessment tools. BACKGROUND Achieving negative margins during BCS is one of the vital factors for preventing local recurrence. Conducting intraoperative margin assessment can ensure negative margins to a large extent and possibly relieve patients of the anguish of re-interventions. In recent years, innovative methods for margin assessment during BCS are advancing rapidly. And there is a lack of summary regarding the development of intraoperative margin assessment in BCS. METHODS A PubMed search with keywords "intraoperative margin assessment" and "breast conserving surgery" was conducted. Relevant publications were screened manually for its title, abstract and even full text to determine its true relevance. Publications on neo-adjuvant therapy and intraoperative radiotherapy were excluded. References from the searched articles and other supplementary articles were also looked into. CONCLUSIONS Conventional methods for margin assessment yields stable outcome but its use is limited because of the demand on pathology staff and the trade-off between time and precision. Conventional imaging techniques pass the workload to radiologists at the cost of a significantly low duration of time. Involving artificial intelligence for image-based assessment is a further improvement. However, conventional imaging is inherently flawed in that occult lesions can't show on the image and the showing ones are ambiguous and open to interpretation. Unconventional techniques which base their judgment on cellular composition are more reassuring. Nonetheless, unconventional techniques should be subjected to clinical trials before putting into practice. And studies regarding comparison between conventional methods and unconventional methods are also needed to evaluate their relative efficacy.
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Affiliation(s)
- Wanheng Li
- First Clinical Medical School, Southern Medical University, Guangzhou, China
| | - Xiru Li
- Department of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing, China
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Breast Reconstruction after Mastectomy with the Use of an Implant and Serratus Anterior Fascia Flap-Initial Clinical Evaluation. J Pers Med 2021; 11:jpm11111142. [PMID: 34834494 PMCID: PMC8623064 DOI: 10.3390/jpm11111142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/27/2021] [Accepted: 11/01/2021] [Indexed: 11/17/2022] Open
Abstract
Prosthesis-based techniques are the predominant form of breast reconstruction worldwide. The most performed surgical technique involves the placement of the expander in a partial submuscular plane. The coverage of the implant remains a difficult management problem that can lead to complications and poor outcomes. The use of the serratus fascia flap may be the best choice to create a subpectoral pocket for the placement of a tissue expander, with excellent results in terms of morbidity and cost-effectiveness. A total of 20 breast reconstructions with the inferolateral coverage with the serratus fascia were performed. Patients demonstrated a low overall complication rate (9.5%), such as seroma and infection, with complete resolution during the follow-up and no major complications. The US examination of the soft tissues over the implant reported thickness measurements that demonstrated a good coverage over the inferolateral area. Our study shows that using the serratus fascia flap to create a pocket with the pectoralis major for the placement of the tissue expander is an effective technique during two-stage breast reconstruction. The resulting low rate of morbidity and the US findings collected reveal the safety of this procedure. Its success relies on appropriate patient selection and specific intraoperative technique principles.
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Casella D, Nanni J, Lo Torto F, Barellini L, Redi U, Kaciulyte J, Cassetti D, Ribuffo D, Marcasciano M. Extended Latissimus Dorsi Kite Flap (ELD-K Flap): Revisiting an Old Place for a Total Autologous Breast Reconstruction in Patients with Medium to Large Breasts. Aesthetic Plast Surg 2021; 45:390-401. [PMID: 33057755 DOI: 10.1007/s00266-020-01990-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 09/19/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND The latissimus dorsi (LD) flap represents one of the most reliable methods for autologous breast reconstruction. However, in many patients, the exclusive use of this technique may not guarantee the restoration of an adequate volume and projection. We report our experience with the extended latissimus dorsi kite flap (ELD-K flap), an alternative surgical approach to maximize the volume of the fleur-de-lis pattern LD flap, for total autologous breast reconstruction. METHODS Between 2016 and 2018, 23 patients were subjected to mastectomy and immediate autologous reconstruction with "extended latissimus dorsi kite flap" (ELD-K flap), technique that employs an extended version of the LD musculocutaneous flap, based on the skeletonized thoracodorsal pedicle and a trilobate skin incision with an inferiorly based vertical branch. The BREAST-Q questionnaire was administered preoperatively, and one year after surgery to evaluate the quality of life results of the patients. BREAST-Q latissimus dorsi module was also provided. RESULTS Average body mass index was 29.7 kg/m2 (range 25-40 kg/m2). Mild complications occurred in only six cases, and eight patients underwent treatment to improve the donor site scar outcome. Patients indicated high scores in quality of life measures with an increase in all BREAST domains from the preoperative to the postoperative period. A statistically significant increase (p < 0.05) was noted in: "overall satisfaction with breasts" (p < 0.05), "psychosocial well-being" (p < 0.05), "physical impact of the surgery" (p < 0.05). Within the LD module, participants reported a mean score of, respectively, 73.8 and 67.9 for "satisfaction with back" and "satisfaction with shoulder and back function" domains. CONCLUSIONS The extended incision allows the recruitment of additional tissue to provide enough volume to complete the reconstruction without implants. The isolation of the vascular pedicle allows for extreme freedom and mobilization of the flap, ensuring adequate filling of the breast. ELD-K flap may expand the indications for a total autologous LD immediate breast reconstruction, representing an additional and reliable alternative in selected cohorts of patients. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Donato Casella
- UOC Chirurgia Oncologica Della Mammella, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Jacopo Nanni
- Department of Surgery, "P. Valdoni", Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Federico Lo Torto
- Department of Surgery, "P. Valdoni", Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Leonardo Barellini
- Unità Di Oncologia Chirurgica Ricostruttiva Della Mammella, "Spedali Riuniti" Di Livorno, "Breast Unit" Integrata Di Livorno Cecina, Piombino Elba, Azienda USL Toscana Nord Ovest, Livorno, Italy
| | - Ugo Redi
- Department of Surgery, "P. Valdoni", Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Juste Kaciulyte
- Department of Surgery, "P. Valdoni", Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Dario Cassetti
- UOC Chirurgia Oncologica Della Mammella, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Diego Ribuffo
- Department of Surgery, "P. Valdoni", Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Marco Marcasciano
- Department of Surgery, "P. Valdoni", Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
- Unità Di Oncologia Chirurgica Ricostruttiva Della Mammella, "Spedali Riuniti" Di Livorno, "Breast Unit" Integrata Di Livorno Cecina, Piombino Elba, Azienda USL Toscana Nord Ovest, Livorno, Italy.
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Zhou Y, Liu Y, Wang Y, Wu Y. Comparison of Oncoplastic Breast-Conserving Therapy and Standard Breast-Conserving Therapy in Early-Stage Breast Cancer Patients. Med Sci Monit 2021; 27:e927015. [PMID: 33384404 PMCID: PMC7784144 DOI: 10.12659/msm.927015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background The aim of this study was to compare the efficacy and safety of oncoplastic breast-conserving therapy (OBCT) and SBCT (standard breast-conserving therapy) in breast cancer surgery. Material/Methods We enrolled 192 breast cancer patients who underwent breast-conserving surgery during January 2015 to April 2018. The surgery strategies of OBCT and SBCT were performed according to the patients’ condition. For measurement of surgical cosmetic effects, the Harris scale, the modified objective scores, and the subjective evaluation were all used. The basic clinical characteristics, intraoperative indices, postoperative complications, metastasis, and recurrence during the 2-year follow-up were recorded. Results The mean surgical time was remarkably longer and the resected volume was markedly larger in the OBCT group than in the SBCT group. The excellent and good ratios of Harris scale, the modified objective scores, and the ratio of very satisfied and satisfied patients by subjective scale were all significantly higher in the OBCT group than in the SBCT group. The occurrence rates of seroma and poor incision healing were remarkably lower in the OBCT group. No significant difference was found for metastasis and recurrence. Conclusions OBCT had better cosmetic effects, fewer complications, and no adverse effects on metastasis and recurrence.
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Affiliation(s)
- Yuan Zhou
- Department of General Surgery, The Affiliated Hospital of Jiaxing University and The First Hospital of Jiaxing, Jiaxing, Zhejiang, China (mainland)
| | - Yixiao Liu
- Department of Stomatology, The Affiliated Hospital of Jiaxing University and The First Hospital of Jiaxing, Jiaxing, Zhejiang, China (mainland)
| | - Yu Wang
- Department of Burn and Plastic Surgery, The Affiliated Hospital of Jiaxing University and The First Hospital of Jiaxing, Jiaxing, Zhejiang, China (mainland)
| | - Yanfei Wu
- College of Foreign Studies, Jiaxing University Jiaxing, Jiaxing, Zhejiang, China (mainland)
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