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Objective: This study aims to explore the application value of chest wall perforator flaps (CWPF) in oncoplastic breast-conserving surgery. Methods: A retrospective review was conducted on 22 early-stage breast cancer patients who underwent oncoplastic breast-conserving surgery using CWPF between January 2021 and December 2022. This included 4 cases (18.2%) utilizing lateral intercostal artery perforator (LICAP) flaps, 10 cases (45.4%) employing lateral thoracic artery perforator (LTAP) flaps, 4 cases (18.2%) combining LICAP and LTAP flaps, and 4 cases (18.2%) using anterior intercostal artery perforator (AICAP) flaps. The perforators used in this study included lateral thoracic artery perforators (LTAP), anterior intercostal artery perforators (AICAP), and lateral intercostal artery perforators (LICAP). In some cases, a combination of LICAP and LTAP was employed to ensure adequate blood supply. All flaps were supplied by dominant perforators, with some cases using multiple perforators to enhance flap perfusion and survival. Our single-center experience with CWPF, including surgical details, complications, aesthetic, and oncological outcomes, is reported. Results: Among all patients, tumors were located in the outer quadrant (68.2%), central quadrant (13.6%), and inner quadrant (18.2%) of the excision cavity. In the 22 patients, 15 tumors were located in the outer quadrant: 6 in the left upper outer quadrant (1–2 o'clock), 4 in the right upper outer quadrant (10–11 o'clock), and 5 in the outer quadrants (3 o'clock in 3 cases and 9 o'clock in 2 cases). Four tumors were in the lower inner quadrant: 2 in the left lower inner quadrant (7–8 o'clock) and 2 in the right lower inner quadrant (4–5 o'clock). Three tumors were in the central area extending toward the outer quadrant. All tumors were located more than 2 cm from the nipple-areola complex (NAC), and intraoperative frozen sections confirmed negative margins behind the NAC. All patients had negative surgical margins. The average operative time was 100.5 ± 10.2 min, with flap lengths ranging from 10 to 18 cm and widths from 4 to 10 cm. All flaps survived, with only one instance of surgical site infection, which improved with conservative treatment. Overall patient satisfaction was rated as excellent or good in 85.6%, and physician evaluation was 89.0% excellent or good. In addition to subjective patient and surgeon satisfaction surveys, objective aesthetic outcomes were evaluated using the BCCT.core software. This tool provided a standardized assessment of breast symmetry, contour, and cosmetic outcomes, enhancing the objectivity and reproducibility of the cosmetic evaluation in the study. The median follow-up period was 14.5 months, with one case of tumor recurrence and no patient mortality. Conclusion: CWPF can be effectively used in small-to-medium volume, non-ptotic breasts for oncoplastic surgery, yielding high patient satisfaction. In the era of oncoplastic breast surgery, chest wall perforator flaps are a reliable and safe option for partial breast reconstruction with acceptable aesthetic results. [ABSTRACT FROM AUTHOR]

Treatment of early breast cancer using breast-conserving surgery (BCS) commonly leads to local control and acceptable cosmetic results. We report a useful technique to achieve symmetry of the breast shape and nipple-areola, with excellent results. A Japanese patient with early breast cancer located in the inner central area of the breast was enrolled in this study. Intraductal spread of breast cancer to the nipple was suspected; however, no invasion was observed outside the nipple wall. We preserved the cylindrical surface, but resected the inner tissue with the top surface of the nipple. After coring the nipple, the remnant cylindrical surface was cut into a spiral shape. Nipple reconstruction using the spiral-peeling technique during oncoplastic breast-conserving surgery (OPBCS) may be useful for patients who desire nipple preservation. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate central quadrantectomy and nipple resection with areola preservation (CQ-NR-AP) as a new reconstructive oncoplastic technique Versus Grisotti flap mammoplasty (GFM) in central malignant tumors of the breast extending to the nipple, in terms of time procedures, breast symmetry, patient satisfaction, postoperative complications, and local recurrence. Patients and methods: The current study is a single-blind, single-center, randomized, controlled trial that was performed between May 2018 and May 2023 in the breast surgery unit of University Hospitals. This trial involved 40 individuals who had central breast lesions that extended to the nipple and were monitored for two years following surgery. Results: As regards the mean intra-operative time in minutes, in the group (I) was 80.1 with a standard deviation of ± 13.9, and ingroup (II) was 138.9 with a standard deviation of ± 14.02 (p = 0.001). The seroma was detected in zero cases in group (I) and 2(10%) cases in group II (p = 0.487) and those two cases were managed by aspiration only. Regarding, the wound infection was found in one case (5%) in group (I) and 3(15%) cases in group II (p = 0.605). Regarding patient satisfaction and breast, symmetry was much better in the group (I). Conclusion: The safety and ease of central quadrantectomy and nipple resection with areola preservation were demonstrated in a two-year follow-up, with a lower incidence of complications compared to the Grisotti flap mammoplasty technique. Furthermore, this approach was associated with higher patient satisfaction, which is a significant achievement in the management of centrally located breast tumors. Trial registration: PACTR202405688323721. 28/05/2024. [ABSTRACT FROM AUTHOR]

Abstract Objectives To evaluate central quadrantectomy and nipple resection with areola preservation (CQ-NR-AP) as a new reconstructive oncoplastic technique Versus Grisotti flap mammoplasty (GFM) in central malignant tumors of the breast extending to the nipple, in terms of time procedures, breast symmetry, patient satisfaction, postoperative complications, and local recurrence. Patients and methods The current study is a single-blind, single-center, randomized, controlled trial that was performed between May 2018 and May 2023 in the breast surgery unit of University Hospitals. This trial involved 40 individuals who had central breast lesions that extended to the nipple and were monitored for two years following surgery. Results As regards the mean intra-operative time in minutes, in the group (I) was 80.1 with a standard deviation of ± 13.9, and ingroup (II) was 138.9 with a standard deviation of ± 14.02 (p = 0.001). The seroma was detected in zero cases in group (I) and 2(10%) cases in group II (p = 0.487) and those two cases were managed by aspiration only. Regarding, the wound infection was found in one case (5%) in group (I) and 3(15%) cases in group II (p = 0.605). Regarding patient satisfaction and breast, symmetry was much better in the group (I). Conclusion The safety and ease of central quadrantectomy and nipple resection with areola preservation were demonstrated in a two-year follow-up, with a lower incidence of complications compared to the Grisotti flap mammoplasty technique. Furthermore, this approach was associated with higher patient satisfaction, which is a significant achievement in the management of centrally located breast tumors. Trial registration PACTR202405688323721. 28/05/2024.

With advancements in oncology and oncoplastic training, the options for treating breast cancer have expanded exponentially over the past two decades. In particular, surgical techniques have advanced to the point where oncological safety and aesthetic outcomes are now the pillars of contemporary breast surgery. Studies have demonstrated that by using oncoplastic techniques, breast conservation has become an alternative for many patients who would otherwise undergo mastectomy. Nonetheless, a considerable cohort of patients will still require, or request, a mastectomy. Surgical options range from a simple wide local excision, therapeutic mammoplasty, volume replacement techniques with a local flap or mastectomy with whole breast reconstruction using autologous tissue or a prosthetic implant. Deciding between surgical options involves careful consideration of tumour characteristics, patient comorbidities and the potential effects of neoadjuvant and adjuvant treatments. The key message for surgeons is to ensure the chosen surgery does not compromise oncological outcomes and provides an excellent aesthetic outcome with timely healing to prevent delays in commencing adjuvant oncology treatments. In this article, we discuss techniques for breast conservation surgery and reconstructive options after mastectomy. In addition, we detail the safety and influence of neoadjuvant and adjuvant treatments on surgery. [ABSTRACT FROM AUTHOR]

Context: Oncoplastic breast surgery is the current standard for treatment of early breast cancer, offering a balance between good cosmetic outcomes and limited risk of locoregional recurrence. Still, the best technique of reconstruction for centrally located breast cancer (CLBC) is not established because of cosmetic issues associated with NAC resection and difficulties associated with its reconstruction. Aims: This study aims to present here a novel technique of post-BCS breast reconstruction for CLBC by latissimus dorsi (LD) flap coupled with immediate NAC reconstruction using modified Skate Flap. Methods and Material: A total of 9 patients underwent oncoplastic breast reconstruction using the described technique for CLBC at our center from July 2018 to March 2020. Postoperative analysis was done for surgical complications, pathological, oncological, and cosmetic outcomes. QOL outcome was assessed using body image scale (BIS) and compared with another group of 9 mastectomy patients operated in the same time period. Statistical Analysis: The analysis was done using SPSS software. P value was calculated using the Independent t-test. Results: Mean BIS score was 4.44 (range 1–8) in BCS vs 20 (range 11–27) in the mastectomy group, signifying better QOL in the BCS group. The postoperative cosmetic results, as evaluated by the patients, were excellent in 7 of 9 patients (77.77%), good in 1 patient (11.11%), and fair in 1 (11.11%), with an overall mean of 4.11 equivalent to 82% satisfaction. Conclusions: Immediate reconstruction with LD flap and modified skate flap following resection of CLBC is a good technique for this difficult group of patients to be managed by BCS. Cosmetic results of this technique are satisfactory. Additionally, it avoids the need for a symmetrizing contralateral breast surgery as well as a second surgery on the ipsilateral breast. [ABSTRACT FROM AUTHOR]

Background: Numerous plastic surgical treatments including volume displacement or replacement techniques vary depending on the tumor position, presence of ptosis, tumor to breast ratio, and surgeon skill Objectives: This study aimed to compare the viability, cosmoses, postoperative complications, and musculoskeletal functional result of volume displacement procedures and the Latissimus dorsi (LD) flap. Patients and methods: 64 patients were divided into two groups and underwent conservative breast surgery and reconstruction using either volume displacement procedures or LD flap. Follow-up for 1 year was planned. The mean age in group A was 38.12 ± 4.16 years whereas it was 39.42 ± 5.46 years in group B. The mean operative time was 174.7 ± 13.55 and 139.7 ± 9.64 minutes in group A and group B respectively (P = 0.001*). There was no significant difference between the 2 groups regarding postoperative complications. In groups A and B demonstrated satisfactory results, with 90.6% of the LD flap and 93.8% of them exhibiting "excellent" and "good" outcomes respectively. When compared at 3 and 6 months intervals in group A, patients had shoulder function disability using SPADI and significant improvement with time (P < 0.001). While, group B showed no signs of shoulder dysfunction. Conclusion: Volume displacement procedures are dependable, more practical, and associated with less postoperative problems than LD flaps. Compared to the LD flap, those procedures offer a much superior cosmetic and, ultimately, functional outcome. [ABSTRACT FROM AUTHOR]

Background: Oncoplastic surgery has become an important part of the surgical repertoire to offer both oncologically safe and aesthetically pleasing results in patients with breast cancer. Data comparing oncoplastic and reconstructive breast surgeries are limited. This study aimed to assess patient-reported outcomes (PRO) in our cohort of oncoplastic and reconstructively operated patients. Methods: Patients who underwent oncoplastic surgery, including immediate reconstruction by a single surgeon, between 2010 and 2018 were contacted to participate in this study. In total, 157 patients fulfilled the inclusion criteria. 54 patient data sets were used for statistical evaluation. Body Image Scale (BIS) and BreastQ questionnaires were used to measure subjective PRO scores, and pictures were taken to objectively measure symmetry using the Breast Analyzing Tool (BAT). Patients were divided into three groups according to the Tübingen classification (group 1: Tübingen 3–4 (n = 16), group 2: Tübingen 5 (n = 26), group 3: Breast Reconstruction/Tübingen 6 (n = 12]). Results: The mean age was 53.5 for group 1, 51.4 for group 2 and 46.8 for group 3. The mean follow-up was 62.9 ± 35.82 months. BIS was significantly better in group 3 (3.92 ± 1.73) than in group 1 and 2 (7.69 ± 4.48 and 4.81 ± 3.41, p = 0.016). Symmetry measured using BAT showed only a trend favoring reconstruction (p = 0.12). The BreastQ item "Sexual well-being" was significantly better in oncoplastic breast reduction surgery (p = 0.036). Conclusion: BIS was better after reconstructive breast surgery than after oncoplastic surgery. Reconstructive breast surgery in experienced breast care units offers high patient satisfaction and a high quality of life. [ABSTRACT FROM AUTHOR]

Purpose: There has been a UK national directive to ensure that patients are offered reconstructive surgical options. We aimed to assess any change in oncoplastic practice over a 10-year period. Methods: The surgical management of 7019 breast cancers was retrospectively assessed at Nightingale Breast Centre, Manchester University UK, from 2010 to 2019. The procedures were categorised into breast conservative surgery (BCS) and mastectomy ± immediate reconstruction. The data were analysed using inclusion and exclusion criteria. Results: The overall rates of BCS and mastectomy were 60.1% and 39.9% respectively. No statistically significant change in the overall rates of BCS or mastectomy was observed over the last decade (p = 0.08). The rate of simple wide local excision (WLE) decreased from 98.7% to 89.3% (p < 0.001), whilst the rate of therapeutic mammoplasty (TM) increased from 1.3% to 8% (p < 0.01). The rate of chest wall perforator flaps (CWPF) changed from zero to account for 2.7% of all BCS by 2019. The overall rate of immediate breast reconstruction (IBR) did not significantly change over the study period, but it consistently remained above the national average of 27%. The rate of implant-based IBR increased from 61.3% to 76.5% (p = 0.012), whilst the rate of Latissimus Dorsi (LD) reconstruction decreased from 26.7% to 5.1% (p < 0.05). Additionally, the rate of nipple-sparing mastectomy significantly increased from 5.2% to 24%. Conclusion: No significant changes in the overall rates of BCS was observed, the rates of advanced breast conservation techniques, nipple-sparing mastectomy, and implant-based IBR all have increased, whilst the use of LD reconstruction decreased. [ABSTRACT FROM AUTHOR]

Background: Partial breast reconstruction with a pedicled chest wall perforator flap (CWPF) enables breast conservation in a higher tumour: breast volume ratio scenario. Since there is limited evidence, this retrospective cohort study aimed to ascertain immediate (30-days) and medium-term (follow-up duration) surgical outcomes. Methods: STROBE-compliant protocol ascertained CWPF outcomes between March 2011–March 2021. UK centres known to perform CWPF were invited to participate if they performed at least 10 cases. Data were retrospectively collected, including patient demographics, tumour and treatment characteristics, and surgical and oncological outcomes. Statistical analysis (R™) included multivariable logistic regression and sensitivity analysis. Results: Across 15 centres, 507 patients with median age (54 years, IQR; 48–62), body mass index (25.4 kg/m2, IQR; 22.5–29), tumour size (26 mm, IQR; 18–35), and specimen weight (62 g, IQR; 40–92) had following flap types: LiCAP (54.1%, n = 273), MiCAP/AiCAP (19.6%, n = 99), LiCAP + LTAP (19.8%, n = 100) and TDAP (2.2%, n = 11). 30-days complication rates were in 12%: haematoma (4.3%, n = 22), wound infection (4.3%, n = 22), delayed wound healing (2.8%, n = 14) and flap loss (0.6%, n = 3; 1 full) leading to readmissions (2.6%, n = 13) and re-operations (2.6%, n = 13). Positive margins (n = 88, 17.7%) led to 15.9% (n = 79) re-excisions, including 7.5% (n = 37) at the planned 2nd of 2-stage surgery and 1.8% (n = 9) mastectomy. At median 23 months (IQR; 11–39) follow-up, there were 1.2% (n = 6) symmetrisations; recurrences: local (1%), regional/nodal (0.6%) and distant (3.2%). Conclusions: This large multicentre cohort study demonstrates acceptable complication and margin re-excision rates. CWPF extends the range of breast conservation techniques. Further studies are required for long-term oncological outcomes.

Breast surgery is the cornerstone of treatment for early breast cancer. Historically, mastectomy and conventional breast-conserving surgery (BCS) were the main surgical techniques for treatment. Now, oncoplastic breast surgery (OBS), introduced in the 1990s, allows for a combination of BCS and reconstructive surgery to excise the cancer while preserving or enhancing the contour of the breast, leading to improved aesthetic results. Although imaging after conventional lumpectomy demonstrates typical postsurgical changes with known evolution patterns over time, OBS procedures show postsurgical changes/fat necrosis in locations other than the lumpectomy site. The purpose of this article is to familiarize radiologists with various types of surgical techniques for removal of breast cancer and to distinguish benign postoperative imaging findings from suspicious findings that warrant further work-up. [ABSTRACT FROM AUTHOR]

Purpose: Autologous breast reconstruction improves patient satisfaction and quality of life after mastectomy. In Germany, free flap surgery and implant-based reconstruction is usually separate between reconstructive surgery and gynecology. Cooperation between the specialist disciplines and implementation of microsurgery into breast surgeon training could enhance surgical treatment for breast cancer patients. This evaluation is intended to demonstrate the learning progress within a microsurgical training program and the complication rate in relation to microsurgical experience. Methods: At the breast cancer center at Klinikum rechts der Isar, TU Munich, a three-stage training program for autologous breast reconstruction and microsurgery for gynecological breast surgeons was developed. Between 2019 and 2022, 74 women received autologous free flap breast reconstruction by a consistent team consisting of a gynecological surgeon in training and an expert microsurgeon. Peri- and postoperative data were collected to analyze the feasibility and safety of a microsurgical training in gynecology. Results: Within the training, operative steps of free autologous breast reconstruction were increasingly taken over by the gynecological surgeon in training. The analysis showed a decrease in operating times with consistently low complication rates during the training. Conclusion: This study demonstrated that a training in free autologous breast reconstruction for gynecological surgeons is safely feasible through close cooperation between gynecological and reconstructive surgery. [ABSTRACT FROM AUTHOR]

Purposes: Breast deformity occurring in the lower pole after breast conserving surgery (BCS) is known as bird's beak (BB) deformity. This retrospective study evaluated the outcomes in breasts reconstructed with a conventional closing procedure (CCP) and a downward-moving procedure (DMP), respectively, after BCS. Methods: In CCP, the inferomedial and inferolateral portions of breast tissues were reapproximated toward the midline after wide excision to repair the breast defect. In DMP, the retro-areolar breast tissue was detached from the nipple–areolar complex after wide excision, and the upper pole breast tissue was moved downward to refill the breast defect. Results: CCP was performed in 20 patients (Group A), and DMP was performed in 28 patients (Group B). Although retraction of the lower part of the breast was postoperatively observed in 13 (72%) of 18 patients from Group A, it was observed in 7 (28%) of 25 patients in Group B (p < 0.05). The downward pointing of the nipple was observed in 8 (44%) of 18 patients from Group A and in 4 (16%) of 25 patients in Group B (p < 0.05). Conclusions: DMP is more useful for preventing BB deformity than CCP. [ABSTRACT FROM AUTHOR]

Introduction: Oncoplastic breast surgery (OBS) combines plastic surgery techniques with conventional breast-conserving surgery (BCS) and expands BCS eligibility. Limited data are available on patient-reported outcomes (PROs) after OBS. Here we compare long-term PROs after OBS and BCS utilizing the BREAST-Q. Patients and Methods: Women undergoing OBS or BCS between 2006 and 2019 who completed ≥ 1 long-term BREAST-Q survey 3–5 years postoperatively were identified. Baseline characteristics were compared between women who underwent OBS/BCS. Women who underwent OBS were paired with those who underwent BCS using 1:2 propensity matching [by age, body mass index (BMI), race, T stage, and multifocality]. BREAST-Q scores were compared preoperatively and 3–5 years postoperatively. Results: A total of 297 patients were included for analysis (99 OBS/198 BCS). Women who underwent OBS were younger (p < 0.001) and had higher BMI (p = 0.005) and multifocal disease incidence (p = 0.004). There was no difference between groups in nodal stage, re-excision rates, axillary surgery, chemotherapy, endocrine therapy, or radiotherapy. After propensity matching preoperatively, women who underwent OBS reported lower psychosocial well-being (63 versus 100, p = 0.039) but similar breast satisfaction and sexual well-being compared with women who underwent BCS; however, only three patients who underwent BCS had preoperative BREAST-Q scores available for review. In long-term follow-up, women who underwent OBS reported lower psychosocial scores (74 versus 93, p = 0.011) 4 years postoperatively, but not at 5 years (76 versus 77, p = 0.83). There was no difference in long-term breast satisfaction or sexual well-being. Conclusions: Women who undergo OBS present with a larger disease burden and may represent a group of non-traditional BCS candidates; they reported similar long-term breast satisfaction and sexual well-being compared with women who undergo BCS. While women who underwent OBS reported lower psychosocial well-being scores preoperatively and during a portion of the follow-up period, this difference was no longer seen at 5 years postoperatively. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Patients who have undergone breast-conserving surgery may experience fear of recurrence. Post-operative granulation tissue and fat necrosis are common issues for these patients. As a result, additional examinations may increase, which can entail increased costs and stress for patients. In this study, if oncoplastic breast-conserving surgery causes additional imaging and unnecessary additional evaluations. PATIENTS AND METHODS: We retrospectively analyzed data from 432 patients who had undergone breast-conserving surgery in the same surgical unit between 2013 and 2017. We separated the patients into two main groups: Group 1 were those operated with conservative breast-conserving surgery, while Group 2 had operations using oncoplastic breast-conserving surgery techniques. The two groups were compared in terms of post-operative radiological examinations, suspected radiological findings, and biopsy needs. RESULTS: There were 203 patients in Group 1 and 229 in Group 2. The median follow-up time was 66 months (range 12-109). Additional mammography use was higher in the second group (p=0.003). However, the two groups had no statistical differences for additional imaging and biopsy needs in general (p=0.138). Sixty-two patients (14.3%) had biopsies with suspicious radiological findings (15.8% vs. 13.1%). Eight (12.8%) of these patients had malignant results. There were local recurrences in six patients, one in the first group and five in the second group (p=0.084). CONCLUSIONS: Oncoplastic breast-conserving surgery may increase post-operative mammography use. However, there is no statistical difference between the two groups for either additional imaging in total or in biopsy needs. [ABSTRACT FROM AUTHOR]

Oncoplastic breast conservation surgery (BCS) uses concurrent reduction and/or mastopexy with lumpectomy to improve aesthetic outcomes. However, tissue rearrangement can shift the original tumor location site in relation to external breast landmarks, resulting in difficulties during re-excision for a positive margin and accurate radiation targeting. We developed the Breast Intraoperative Oncoplastic (BIO) form to help depict the location of the tumor and breast reduction specimen. This study seeks to assess physician perspectives of the implementation outcomes. From February 2021 to April 2021, the BIO form was used in 11 oncoplastic BCS cases at a single institution. With institutional review board approval, surgical oncologists (SOs), plastic surgeons (PSs), and radiation oncologists (ROs) were administered a 12-question validated survey on Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), and Feasibility of Intervention Measure (FIM), using a 5-point Likert scale during initial implementation and at 6-month reassessment. Twelve physicians completed the survey initially (4 SOs, 4 PSs, and 4 ROs). The mean scores for Acceptability of Intervention Measure, Intervention Appropriateness Measure, and Feasibility of Intervention Measure were high (4.44, 4.56, and 4.56, respectively). Twelve completed the second survey (5 SOs, 3 PSs, and 4 ROs). The mean scores were marginally lower (4.06, 4.21, and 4.25). There were no significant differences when stratified by number of years in practice or specialty. Free text comments showed that 75% of physicians found the form helpful in oncoplastic BCS. The data indicate high feasibility, acceptability, and appropriateness of the BIO form. Results of this study suggest multidisciplinary benefits of implementing the BIO form in oncoplastic BCS. [ABSTRACT FROM AUTHOR]

Partial breast reconstruction with a pedicled chest wall perforator flap (CWPF) enables breast conservation in a higher tumour: breast volume ratio scenario. Since there is limited evidence, this retrospective cohort study aimed to ascertain immediate (30-days) and medium-term (follow-up duration) surgical outcomes. STROBE-compliant protocol ascertained CWPF outcomes between March 2011–March 2021. UK centres known to perform CWPF were invited to participate if they performed at least 10 cases. Data were retrospectively collected, including patient demographics, tumour and treatment characteristics, and surgical and oncological outcomes. Statistical analysis (R™) included multivariable logistic regression and sensitivity analysis. Across 15 centres, 507 patients with median age (54 years, IQR; 48–62), body mass index (25.4 kg/m2, IQR; 22.5–29), tumour size (26 mm, IQR; 18–35), and specimen weight (62 g, IQR; 40–92) had following flap types: LiCAP (54.1%, n = 273), MiCAP/AiCAP (19.6%, n = 99), LiCAP + LTAP (19.8%, n = 100) and TDAP (2.2%, n = 11). 30-days complication rates were in 12%: haematoma (4.3%, n = 22), wound infection (4.3%, n = 22), delayed wound healing (2.8%, n = 14) and flap loss (0.6%, n = 3; 1 full) leading to readmissions (2.6%, n = 13) and re-operations (2.6%, n = 13). Positive margins (n = 88, 17.7%) led to 15.9% (n = 79) re-excisions, including 7.5% (n = 37) at the planned 2nd of 2-stage surgery and 1.8% (n = 9) mastectomy. At median 23 months (IQR; 11–39) follow-up, there were 1.2% (n = 6) symmetrisations; recurrences: local (1%), regional/nodal (0.6%) and distant (3.2%). This large multicentre cohort study demonstrates acceptable complication and margin re-excision rates. CWPF extends the range of breast conservation techniques. Further studies are required for long-term oncological outcomes. This is the analysis of the largest aggregated cohort of patients (n=507, 2011-2021, 15 UK centres) undergoing partial breast reconstruction with a pedicled chest wall perforator flap to avoid deformity following breast conservation. Data demonstrates its applicability in T1-T2 tumours (median size,26 mm, IQR;18-35) with re-excision rates of 15.9 (7.5% during the planned second stage) and 1.8% completion mastectomy. Postoperative complication rates were 4.3% haematoma, 4.3% wound infection, 2.8% delayed wound healing, and 0.2% total flap loss. This study demonstrates that CWPF is a valuable option for patients with a higher tumour-to-breast volume ratio who wish to pursue breast-conserving surgery. [Display omitted] • PartBreCon study : A retrospective cohort study of partial breast reconstruction. • 15 centres, n = 507; T2 (26 mm), Breast conservation in 73.4% A-C cups, BMI (25.4). • Chest Wall Perforator Flaps - LiCAP (54%), AiCAP (19%), LiCAP-LTAP (20%), TDAP (2%). • Shows acceptable complications (12%) - re-operations (2.6%), flap loss (0.6%). • Low Mastectomy (2%) & Low Symmetrisation (1%); FU (23 m), local recurrence (1%). [ABSTRACT FROM AUTHOR]

The use of Indocyanine green angiography (ICG-A) in oncoplastic breast-conserving surgery (OBCS) has not yet been investigated. This prospective trial applied ICG-A in volume displacement and replacement OBCS to localize perforators and determine tissue supplied by the perforator. Furthermore, to investigate and correlate the intraoperative ICG-A to postoperative surgical site infection, skin necrosis, epidermolysis, and timely onset of adjuvant therapy. ICG-A was performed at three pre-set timepoints during surgery; after lumpectomy, upon dissection of possible perforators, and after wound closure. All patients were followed with clinical evaluations before surgery, 4 weeks, 4–6 months, and 12 months postoperatively. Eleven patients were included: seven volume displacement and four volume replacement OBCS. ICG-A located the tissue supplied by the perforator and demonstrated sufficient perfusion in all cases. The ICG-A corresponded to the surgeons' clinical assessment. One patient developed a postoperative infection and seroma and was treated conservatively. No patients had postoperative necrosis, loss of reconstruction, or lymphedema of the arm. Edema of the breast occurred in four patients (36.4%). Scar assessments were significantly worse at 4-weeks and 4–6 months. The quality of life improved significantly during follow-up. Adjuvant treatment was administered timely in all cases. ICG-A was feasible for OBCS in assessing intraoperative perfusion. Perfusion was sufficient in all patients and corresponded to the surgeon's clinical evaluation. No patients developed postoperative necrosis. Though edema of the breast occurred in 36.4%, a larger sample size is needed to investigate a possible correlation with ICG-A. Further studies, which includes patients requiring extensive tissue replacement challenging the borders of perfusion, are needed. [ABSTRACT FROM AUTHOR]

Background: Because of resource constrains in sub-Saharan African countries, breast-conserving surgery (BCS) has no role in patients with locally advanced breast cancer (LABC) following neoadjuvant chemotherapy (NACT), and mastectomy remains the standard surgical treatment for these patients. Objectives: The first objective of the study was to assess the safety of oncoplastic BCS in patients with LABC who showed good clinical response to NACT in a breast center with enhanced level of resources in Sudan. The second objective was to assess the cosmetic outcome. Patients and Methods: Two hundred and fifty patients with LABC were treated with NACT at Khartoum Breast Care Center during the period 2013–2019. Out of this, 52 patients were surgically treated with oncoplastic breast-conserving surgery. Kaplan-Meier curve was used to calculate the survival rates. The cosmetic outcome was subjectively assessed by the Harris scale. Results: The median follow-up period was 53 months. The 3- and 5-years distant metastasis-free survival rates were 92.9% and 82.2%, respectively. One patient developed regional recurrence, and 6 patients developed distant metastasis. Eighty percentage of patients were admitted to have good to excellent cosmetic outcome. Conclusion: This Sudanese experience showed that oncoplastic BCS is oncologically safe and aesthetically satisfactory in patients with LABC who demonstrated good clinical response to NACT in a setting with enhanced levels of resources for breast cancer care. [ABSTRACT FROM AUTHOR]

Introduction: The oncoplastic conservative surgery was developed as a natural evolution of traditional surgery, attempting to improve the therapeutic and aesthetic outcomes where tumor resection could be followed by not-adequate results. Our primary aim is to evaluate how patient satisfaction and quality-of-life after conservative oncoplastic surgery, using BREAST-Q (BCT Module), change pre- and post-operatively. The secondary aim is to compare patient-reported outcome after oncoplastic or traditional conservative surgery. Patients and methods: We enrolled 647 patients who underwent traditional conservative surgery or oncoplastic surgery from January 2020 to December 2022. Only 232 women (35.9%) completed the BREAST-Q questionnaire on a web-based platform, at the preoperative phase and 3 months after treatment. Results: The average score of "Psychosocial well-being" and "Satisfaction with Breasts" 3 months after surgery showed a statistically significant improvement, while the average score for "Physical well-being: Chest" at 3 months showed a worsening compared to the baseline. "Sexual well-being" did not show statistically significant change. A significant difference between the post-operative outcome of oncoplastic surgery and traditional surgery was observed only for Physical well-being (better for traditional surgery). Conclusions: The study showed significant improvement in patient-reported outcomes 3 months after the surgery, except for physical discomfort that increases especially after oncoplastic surgery. Furthermore, our data, as well as many others, point to the appropriateness of using OCS where there is an effective indication, while the perspective of patients cannot find significant superiority over TCS in any of the areas analyzed. [ABSTRACT FROM AUTHOR]

This article provides an overview of the principles and techniques of oncoplastic and reconstructive breast surgery for patients with early-stage breast cancer. Oncoplastic breast surgery (OPBS) with partial breast reconstruction is a natural evolution in the application of breast conserving surgery and permits wide surgical resection of tumours that might otherwise mandate mastectomy and whole breast reconstruction. These reconstructive techniques must be optimally selected and integrated with ablative breast surgery together with non-surgical treatments such as radiotherapy and chemotherapy that may be variably sequenced with each other. A multidisciplinary approach with shared decisionmaking is essential to ensure optimal clinical and patient-reported outcomes that address oncological, aesthetic, functional and psychosocial domains. Future practice of OPBS must incorporate routine audit and comprehensive evaluation of outcomes. [ABSTRACT FROM AUTHOR]

Background: Oncoplastic breast surgery is more likely to achieve superior aesthetic outcomes compared to lumpectomy alone. Oncoplastic reduction mammoplasty (ORM) is a volume displacement oncoplastic technique that combines lumpectomy and reduction mammoplasty. Data on aesthetic and quality-of-life (QoL) outcomes after ORM are scarce in the literature. Based on a literature review, this present study reports outcomes on the largest group of ORM patients to date. Methods: A retrospective review was conducted of all patients who underwent ORM between 2011 and 2018 at a tertiary care centre. Patients were excluded if no pedicle information was available or did not undergo post-operative radiotherapy. All patients with available post-operative photographs were aesthetically evaluated by four blinded, independent investigators blinded based on breast symmetry, nipple symmetry, and overall appearance. The BREAST-Q (breast conserving module) was used to assess QoL outcomes. Results: Two-hundred-and-sixteen consecutive patients (223 breasts) were included. Macromastia (cup size D or higher) was present in 173 patients (80.1%). Inferior pedicle ORM was utilized in 179 (80.3%) breasts. Eighty-eight patients (40.7%) were aesthetically evaluated, of whom 69 patients (78.4%) had "good", "very good", or "excellent" grades in all aesthetic categories. Seventy-five patients (85.2%) had "good" or better grades in overall appearance. Preoperative ptosis grade, cup size, presence of post-operative complications, and breast specimen weight had no significant correlations with aesthetic grades. Inferior pedicle ORM was associated with a higher "satisfaction with breast" Q-score (p=0.017) compared to other pedicle approaches. Conclusion: Inferior pedicle ORM achieves objectively excellent aesthetic outcomes and high patient satisfaction with the reconstruction. 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. [ABSTRACT FROM AUTHOR]

Background: Over 30% of breast cancers in the UK are diagnosed in elderly women (age ≥ 70). Women in this age group are less likely to undergo primary surgery for breast cancer, and those who are treated with surgery are more likely to receive a mastectomy. Compared to simple wide local excision, oncoplastic breast surgery (OBS) can reduce re-operation rates, including in larger cancers, and yet maintain/improve breast aesthetics. Despite these advantages, older women are largely underrepresented in the available literature. Methods: To explore the utility of OBS in women aged ≥ 70 years in a well-established surgical practice, a retrospective review of patients undergoing breast-conserving surgery was performed. Tumour characteristics, operative variables and adjuvant treatment details of elderly patients were compared with the younger cohort. Results: A total of 325 patients underwent breast-conserving surgery during the study period including 60 who underwent OBS (22.64%). In fit/operable elderly women, despite greater cancer size, OBS was minimal (n = 1/52, 1.96%), likely due to multi-factorial reasons such as the multidisciplinary team's subconscious age bias or assumptions against qualitatively escalated surgery. In contrast, more patients (n = 6/52, 11.76%) were deemed fit for cytotoxic chemotherapy. Conclusions: Whilst OBS-related benefits certainly should be weighed against the increased risks of a longer operative time and recovery, balanced considerations should be made when considering the escalation of systemic adjuvant treatments and related side-effects vis-à-vis de-escalation of surgery and relation to physical and psychological considerations. Level of Evidence: Level IV, Risk / Prognostic Study. [ABSTRACT FROM AUTHOR]

Background- The purpose of this study was to assess the effectiveness of oncoplastic surgical management for benign phyllodestumour. Methods- Patients (n = 37) with eligible breast benign phyllodestumour underwent oncoplastic surgical management. Primary outcome measures included, postoperative recurrence, and intra-operative and postoperative complications. Results- Thirty-seven patients who underwent surgical excision and oncoplastic breast surgery. The age range of the patients was 42 to 58 years. The majority of breast lesions were between 5 and 10 cm in size, ranging in size from 3.5 to 12.5 cm. On the seventh post-operative day, 56.8% of patients reported pain at the surgical site, 10.8% of patients had seroma, 5.4% had wound infections, 5.4% had flap necrosis, and 21.6% had lymphedema. Pain observed On Day 7 (56.8% of patients), there were 21 patients; on Day 21, there were 5 patients (13.5% of patients). There was a statistically significant difference in the proportion (P=0.001). Conclusions-Surgery and oncoplastic breast surgery are safe and effective for benign phyllodestumours. Oncoplastic breast conservation surgery allows greater parenchymal resection without compromising oncology or aesthetics. Histopathological analysis pre-operatively reduces recurrences, reoperations, and oncologic outcomes. It can also prevent adjuvant therapy delays. [ABSTRACT FROM AUTHOR]

This article provides an overview of the principles and techniques of oncoplastic and reconstructive breast surgery for patients with early-stage breast cancer. Oncoplastic breast surgery (OPBS) with partial breast reconstruction is a natural evolution in the application of breast conserving surgery and permits wide surgical resection of tumours that might otherwise mandate mastectomy and whole breast reconstruction. These reconstructive techniques must be optimally selected and integrated with ablative breast surgery together with non-surgical treatments such as radiotherapy and chemotherapy that may be variably sequenced with each other. A multidisciplinary approach with shared decision-making is essential to ensure optimal clinical and patient-reported outcomes that address oncological, aesthetic, functional and psychosocial domains. Future practice of OPBS must incorporate routine audit and comprehensive evaluation of outcomes.

Oncoplastic breast surgery involves immediate reshaping of the breast after tumor excision. It enables wider excision of the tumor while maintaining a satisfactory cosmetic outcome. One hundred and thirty seven patients underwent oncoplastic breast surgery at our institute between June 2019 and December 2021. The procedure performed was decided based on the location of tumor and volume of excision. All patient and tumor characteristics were entered into an online database. The median age was 51 years. The mean tumor size was 3.666 cm (± 0.2512). Twenty-seven patients underwent a type I oncoplasty, 89 patients type 2 oncoplasty, and 21 patients a replacement procedure. Only 5 patients had margin positivity out of which 4 patients underwent a re-wide excision with negative margins. Oncoplastic breast surgery is a safe and effective method to manage patients who need conservative surgery of breast tumors. It allows us to provide good esthetic outcome to the patients ultimately aiding in better emotional and sexual well-being. [ABSTRACT FROM AUTHOR]

Purpose: Even if favorable cosmetic outcomes are obtained shortly after breast-conserving surgery (BCS), cosmetic changes may occur up to several years after BCS. In the present study, we evaluated cosmetic changes while focusing on changes in the nipple position after BCS. Methods: We examined the long-term course of changes in the nipple position over time after BCS using the proportion of the distance between the sternal notch and nipple (PDSN) in 196 patients. We also evaluated risk factors for long-term nipple position changes. Results: The median follow-up period was 9.9 years. Nipple position changes occurred within eight years after BCS and seemed to plateau beyond that point. The body mass index (BMI), breast size, proportion of excision volume and axillary treatment were significantly associated with the nipple position changes within one to five years after BCS. The BMI, breast size, axillary treatment, chemotherapy and hormonal therapy were significantly associated with the nipple position changes within five to eight years after BCS. Conclusions: After BCS, the nipple position changes occur within about eight years. Obesity, large breast size, large excision volume, axillary treatment, chemotherapy and hormone therapy were factors that affected the treated breast shrinkage and increase in the left–right difference after BCS. [ABSTRACT FROM AUTHOR]

Background: Surgical wound complications cause substantial morbidity. Data on the effectiveness of closed incision negative pressure wound therapy (ciNPWT) as a prophylaxis of surgical wound complications in oncoplastic breast surgery (OPBS) is sparse. This study assessed the routine prophylactic use of ciNPWT in OPBS, explored the trend in outcomes associated with its application and compared subsequent wound outcomes with the existing literature., Method: A single-surgeon retrospective analysis was conducted on OPBS patients from January 2017 to December 2018. Cumulative sum (CUSUM) analysis was adopted to track the trend of wound complication rates over time. Following the exclusion of data potentially skewed by early procedural adaptation, the study compared the remaining cohort's wound complication rates to those reported in current literature., Results: A total of 209 breast wounds post OPBS were included in the analysis. CUSUM analysis revealed a higher rate of complications at the initial phase of ciNPWT implementation, which significantly decreased and plateaued after eleven months, indicating improved outcome (p < 0.001). Complication rates in the first month of ciNPWT introduction were markedly higher than in the subsequent two-year period (p = 0.02) and was omitted from further analysis. The final ciNPWT cohort showed a significantly lower complication rate than standard dressing usage reported in published studies (16.7 % versus 33.9 %, p < 0.001)., Conclusion: Adoption of prophylactic ciNPWT resulted in gradual decline of wound complications over time, thus shows significant promise in enhancing wound outcomes post OPBS., Competing Interests: Conflict of interest statement None., (Crown Copyright © 2025. Published by Elsevier Ltd. All rights reserved.)

Introduction: Therapeutic mammaplasty (TM) facilitates large tumour resection while maintaining optimal aesthetic outcome. It carries higher wound complication risks, which may delay adjuvant therapy initiation. Whether this delay affects oncological outcome requires evaluation., Methods: Data were collected for consecutive patients receiving TM at the Leeds breast unit (2009-2017). A prospectively maintained database was used to determine tumour characteristics, wound complication rates, receipt of adjuvant therapy and breast cancer recurrence or death., Results: In total 112 patients (median age of 54 years) underwent 114 TM procedures. The most common histological subtypes were invasive ductal carcinoma (61.4%), invasive lobular carcinoma (13.2%) and ductal carcinoma in situ (13.2%). Of the patients, 88.2% had oestrogen receptor-positive cancer and 14% had human epidermal growth factor receptor-positive cancer; 26.3% had multifocal cancer. The median tumour size was 30mm. The median Nottingham Prognostic Index was 4.2. The local recurrence rate was 3.5% (median follow-up of 8.6 years). The 5- and 10-year disease-free survival (DFS) was 88.5% and 83.5%, and the equivalent overall survival (OS) rates were 94% and 83.5%. Wound complication rate was 23.6% ( n =27), the commonest being wound infection (11.4%; n =13) and T-junction wound breakdown (10.5%; n =12). The median time to adjuvant therapy was 72 days (interquartile range [IQR] 56-90) for patients with wound complications, and 51 days (IQR 42-58) for those without. However, this delay did not affect DFS or OS (log-rank test; p =0.58 and p =0.94, respectively). This was confirmed on Cox regression analysis., Conclusion: Our study finding demonstrates that although wound complications after TM leads to a modest delay to adjuvant therapy, the long-term oncological outcomes were comparable with those in patients without wound complications.

The technique of implant immediate breast reconstruction has been revived since the advent of acellular dermal matrices (ADM). The traditional technique involving sub-pectoral implant placement is being replaced by the re-emerging technique of muscle-sparing pre-pectoral implant placement due to the availability of ADM, which can wrapped around the implant, thereby obviating the need for any additional tissue cover. Braxon® (DECO Med s.r.l., Marcon, Italy), a novel ADM, specifically designed for breast reconstruction, is gaining popularity among surgeons in the UK and Europe. Its early outcomes seem promising; however, the literature to back its utility is still scarce. Hence, there is a need to gather and compile the existing evidence to inform the current clinical practice. A systematic review was carried out for all the original studies reporting the outcomes of pre-pectoral implant breast reconstruction with Braxon® through MEDLINE and CINAHL databases. Studies were selected and analyzed based on their level of evidence, inclusion and exclusion criteria for pre-pectoral implant breast reconstruction, and outcomes in terms of complication rates and cosmesis. Six studies (742 breast reconstructions in 600 patients) were identified for the review. All of the studies were level IV evidence case series, reporting outcomes for at least three months post-operative follow-up. All except one study mentioned patient selection criteria based on Association of Breast Surgery (ABS) and British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS) guidelines. Pooled complication rates showed that total 209 (28.2%) breast reconstructions had some form of complication; major complication rate of 98 (13.2%), return to theater 90 (12.1%), implant loss 48 (6.5%), minor complications 111 (15%), seroma 74 (10%), hematoma 29 (3.9%), Red breast syndrome 38 (5.1%), infection 26 (3.5%), necrosis 26 (3.5%), and wound dehiscence 24(3.2%). The short-term pooled complication rates of pre-pectoral implant breast reconstruction with Braxon® are low and comparable with those of the sub-pectoral technique. Although preliminary data are promising; however, the long-term outcomes are yet to be analyzed in future studies., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2025, Karwasra et al.)

Abstract Background Breast conserving surgery (BCS) has been a standard procedure for the treatment of breast cancer instead of mastectomy whenever possible. Lateral chest wall perforator flaps are one of the volume replacement techniques that participate in increasing the rate of BCS especially in small- to moderate-sized breasts with good cosmetic outcome. In this study, we tried to evaluate the outcome of those flaps as an oncoplastic procedure instead of the conventional flaps. Methods This study included 26 patients who underwent partial mastectomy with immediate reconstruction using lateral chest wall perforator flaps in the period from October 2019 to November 2020. The operative time, techniques, and complications were recorded. The cosmetic outcome was assessed 3 months post-radiation therapy through a questionnaire and photographic assessment. Results Lateral intercostal artery perforator (LICAP), lateral thoracic artery perforator (LTAP) and combined flaps were performed in 24, 1, and 1 patients, respectively. The mean operative time was 129.6 ± 13.2 min. The flap length ranged from 10 to 20 cm and its width from 5 to 9 cm. Overall patients’ satisfaction was observed to be 88.5% as either excellent or good and the photographic assessment was 96.2% as either excellent or good. Conclusions Lateral chest wall perforator flaps are reliable and safe option for partial breast reconstruction with an acceptable aesthetic outcome. In the era of oncoplastic breast surgery, they deserve to gain attention especially with the advantages of some modifications added to the classic technique.

This study aimed to evaluate complication rates, patient satisfaction, and cosmetic outcomes after oncoplastic breast-conserving surgery (OPS). Furthermore, outcome differences between volume displacement and volume replacement techniques and the effect of postoperative complications on outcomes were evaluated. This was a prospective single-center study addressing patients who underwent OPS from 2017 to 2020. The BREAST-Q was used to measure patient satisfaction, and cosmetic outcomes were assessed by patient self-evaluation and panel evaluation based on medical photographs. A total of 75 patients were included. The overall complication rate was 18.7%, of which 4% required invasive interventions. Median BREAST-Q scores ranged from 56 to 100 and cosmetic outcomes were scored good to excellent in 60–86%. No differences in complications were observed between volume replacement and volume displacement techniques. Following volume displacement techniques, patients-reported higher BREAST-Q scores for the domain "physical well-being of the chest" and lower cosmetic outcomes scores for "mammary symmetry." Patients with complications scored significantly lower on several domains of the BREAST-Q and in various cosmetic outcome categories. In this cohort, an overall complication rate of 18.7% was observed. Patients were generally satisfied, and most cosmetic outcomes were good to excellent. Volume displacement or replacement techniques were performed for different indications and generally showed comparable results. Expected differences in physical discomfort and symmetry between both techniques were observed. In addition, the occurrence of complications resulted in lower patient satisfaction and cosmetic outcomes. These findings emphasize the importance of thorough preoperative counselling. [ABSTRACT FROM AUTHOR]

Aims: This study explores how women diagnosed with breast cancer may be supported by physicians and nurses during physical and existential changes related to oncoplastic breast surgery in Denmark. The following research questions were addressed: (a) how do women experience oncoplastic breast surgery, and (b) how does cancer treatment affect their body image? Design: A descriptive qualitative study design with a six‐step thematic analysis influenced by Braun and Clarke was applied in this study. This paper has been prepared in accordance with the consolidated criteria for reporting qualitative research. Methods: Fourteen in‐depth interviews with seven women diagnosed with breast cancer were conducted from August 2018 to March 2019. In this qualitative study, data analysis was performed concurrent with data construction, recognizing that the process of analysis and making sense of data should start during the interviews. We explicitly frame the discussion of the findings in a theory of embodiment influenced by Merleau‐Ponty, consistent with the construct of exploring human experiences to generate meaningful knowledge for applied practice. Results: Two overall themes with related subthemes were identified: (1) 'Treatment is required for life‐threatening cancer', and (2) 'Striving for a new normal body'. Across both themes, women's experiences reflected a 'time pendulum' as they contemplated their past identity, their current rationale and their transition to a future beyond breast cancer with a changed body. Conclusion: Participants reflected on their past, present and future when facing an altered body image caused by their breast cancer diagnosis and oncoplastic breast surgery. The participants in the study expressed broad levels of satisfaction with the results of the oncoplastic breast surgery. The reconstructed breast helped them to live normally again, in particular maintaining interpersonal relationships. Breast reconstruction supported participants' embodiment experiences and redefinition of their 'new normal'. Impact This study showed the dynamic changes in self‐definition from receiving a breast cancer diagnosis and cancer treatment to oncoplastic breast surgery. The main finding of self‐redefinition was from the perspective of breast cancer women who were in a period of transition between post‐diagnosis and consultation for oncoplastic breast surgery. The findings indicate that advanced nurse specialists in the field of oncoplastic breast surgery can enhance psychosocial wellbeing and support women pre‐ and post‐operatively by focusing on patient experiences of self‐image and embodiment. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer, the second leading cause of cancerrelated mortality, poses unique challenges to patients, encompassing physical, emotional, and sexual dimensions. Surgical interventions, such as modified radical mastectomy and breast-conserving surgery (BCS), can exacerbate these challenges. This study explores the integration of oncoplastic breast surgery to address shortcomings associated with traditional approaches. Methods: A systematic review of PubMed, Web of Science, and Scopus identified 28 relevant studies, encompassing 28,162 patients. Cosmetic outcomes and patient satisfaction were compared between oncoplastic breast surgery (OBCS) and BCS groups, with a focus on psychological and physical well-being domains. Results: The meta-analysis revealed that OBCS demonstrated superior outcomes in satisfaction with breast appearance, psychological well-being, and physical well-being compared to BCS. Patient satisfaction questionnaire results consistently favored the OBCS group. Recurrence Risk: A meta-analysis estimated a significant reduction in the odds of recurrence in OBCS patients with positive margins (odds ratio = 2.44, P<0.001). This underscores the oncological safety of oncoplastic techniques. Evolution of Breast Cancer Surgery: Oncoplastic breast surgery represents a pivotal advancement in breast cancer surgery. The convergence of surgical oncology and plastic surgery has allowed continual refinement of techniques, ensuring both oncological safety and improved quality of life. Conclusion: Accumulating evidence suggests that oncoplastic breast surgery plays a crucial role in achieving wide local resection with enhanced safety margins for malignant breast tumors. By preserving aesthetic and symmetrical breast shapes, oncoplastic procedures contribute to improved patient outcomes, reinforcing the evolving landscape of breast cancer surgery. [ABSTRACT FROM AUTHOR]

Background: Patient concerns with aesthetics have prompted the improvement of oncoplastic surgical approaches. It has been shown that the aesthetic success in breast malignancy surgical treatment leads enhanced sexual and social recovery. In this study a prospective comparison between cohorts of early-stage breast cancer patients treated with oncoplastic breast surgery. The first cohort will be treated with the single incision approach and the second cohort will be treated by the conventional breast conservative technique, which will be performed with double incision (one for the tumour resection and the other for the axillary dissection). Objective: to compare between single incision & separate incisions in approach to axillary lymph nodes in oncoplastic breast surgery. Patients and Methods: This is a prospective cohort comparative study between single incision & separate incisions in approach to axillary lymph nodes in oncoplastic breast surgery. This study will be conducted at breast surgery unit at Ain Shams University Hospitals and Maddi Military Complex starting from June 2022 to June 2023. Approval of the Ethical Committee and written informed consent from all participants will be obtained. Results: There was significant no statistical difference in both group as regards the operative timing, seroma and the hospital stay but there is a statistical difference regarding hematoma between the two groups. In our study, 86.7% of the patients attained good to excellent cosmetic outcomes (70% as excellent and 26.7% as good) regarding single incision and 79.7% of the patients attained good to excellent cosmetic outcomes (65% as excellent and 26.7% as good) regarding separate incision. High cosmetic outcome was obtained as the patients were satisfied with presence and shape of their breasts relatively. Conclusion: The choice of the oncoplastic technique is mainly based upon the location of the tumor, size of the breast and distance of the tumor from the nipple areola complex. So all cases should be adequately reviewed in order to tailor the decisions for every single case. There is statistically difference between Single incision in breast cancer lesion and separate incision as regards hematoma and the cosmetic outcome. [ABSTRACT FROM AUTHOR]

Objective: Oncoplastic breast surgery is the standard of care in most of the breast cancer patients. In developing countries, patients often present with larger tumors resulting in larger resection. Lattisimus dorsi(LD) flap has been a workhorse flap for partial breast reconstruction. We present our experience using a transposition flap based on the principle of dermal-subdermal blood supply for defects in the outer quadrants of the breast. Materials-Methods: Ten women who underwent oncoplastic breast surgery using transposition flap from lateral chest wall tissue between March 2023 and Feburary 2024 were included in the study. Patients with tumors involving the outer quadrants of the breast were included, irrespective of the age of the patient, body mass index or smoking history. Results: The median age was 37 years (26–68 years). Out of 10, 08 had upfront surgery. Average Tumor size was 2.7 cm and 2.2 cm in upfront and post-neoadjuvant chemotherapy(NACT) patients, respectively. All patients undergoing upfront surgery had the axillary sampling procedure, and if node positive, had a complete axillary lymph node dissection up to level 3. Those who were operated post-NACT underwent complete ALND up to level 3. The average volume of resected specimen was 290 ml and 250 ml for the upfront and post-NACT cases, respectively. Majority (06/10,) of the tumors were in upper outer quadrant (UOQ).Only one patient developed seroma. There was no flap necrosis in any patient. At a median follow up of 7 months, cosmetic outcomes were good in all patients. Conclusions: Transposition flap form lateral chest wall based on the dermal-subdermal plexus can be effectively used as an alternative to LD flap for outer half breast defects. It is easy to learn, does not need the use of magnification and hand help doppler system making it an excellent choice for reconstruction. [ABSTRACT FROM AUTHOR]

Objective: The desire to have knowledge on oncoplastic breast surgery (OBS) has accelerated with the increasing popularity of OBS among surgeons in recent years. Bibliometrics is the holistic analysis of scientific publications or documents. In this study, we aimed to use bibliometric analyses to determine how articles about OBS, published between the years 2000-2023, have progressed according to the Web of Science database, and to identify future trends necessary to contribute to the scientific literature. Materials-Methods: The research data was sourced from the search engine of Thomson Reuters®, Web of Science Core Collection, by using the keyword “Oncoplastic Breast Surgery”, and by choosing the “Topic” section on October 19, 2023. Only “Articles” in “English” were included in the study protocol. The publication number, rates, citation, and h-index data were evaluated according to years, countries, journal categories, organizations, and authors. In addition, publication metrics were evaluated in terms of Gross Domestic Product (GDP), Gross Domestic Product per capita (GDPpp), and Human Development Index (HDI) of the countries. Results: Since 2000, 1469 publications have been published on OBS. Only articles in English (n=930) were assessed. H-index of the 930 articles in English was 50. In the analysis of citation numbers, it was seen that the articles focusing on OBS were cited 12930 times (including selfcitations). The most productive countries, scientific journals, and authors are United States of America, Breast, and Losken A, respectively. There was a positive correlation between the number of publications and GDP (r=0.848, p=0.002) as well as between the number of publications and GDPpp (r=0.726, p=0.018). Conclusions: Rapid growth in the publication productivity indexed on OBS means that the field is receiving more and more attention from researchers. This advancement emphasizes the benefits of bibliometric analysis, which is helpful to researchers in providing directions for future studies. [ABSTRACT FROM AUTHOR]