الفهرس | Only 14 pages are availabe for public view |
Abstract Breast cancer is the second most common cancer among women following skin cancer, with an estimated 3.5 million survivors as of 2015. There is continuous annual improvement of the overall survival of breast cancer patients, with 5-year overall survival estimates increasing from 84.6% to 90.9% over the previous two decades. Surgical treatment of breast cancer has undergone Marvelous changes over the past three decades. The results of large randomized clinical trials held in Europe and North America documented that the oncologic safety of breast conserving therapy is equal to modified radical mastectomy. For most patients presented by early breast cancer, Breast Conserving therapy (BCT) followed by radiotherapy has become the preferred treatment. BCT, in addition to oncologic safety, improves the body image and lifestyle. However, the aesthetic results of BCT were not satisfying in some challenging scenarios. The integration of plastic and reconstructive surgery in breast cancer surgery to achieve the best aesthetic outcome with compromising the oncologic safety is termed Oncoplastic Breast Surgery (OPBS). OPBS is not a new term and it is comparable to the ordinary BCT as regarding the margin status and the recurrence rates. Oncoplastic procedures applied to facilitate removal of larger volume of breast tissue with less deformity which is much easier than postoperative correction. OPBS is classified into volume displacement, by closing the lumpectomy defect using local breast issue to redistribute the respected volume over the remaining breast tissue, and volume replacement by using tissues other than the breast to fill the lumpectomy defect. Breast cancer in the Upper Outer Quadrant (UOQ) of the breast can be excised safely without causing deformity except when more than 20% of breast tissue is removed. In such case, the skin is retracted and the Nipple- Areola Complex (NAC) is pulled towards the incision site. Planning the incision location is an essential step in oncoplastic breast surgery. Visible scarring can be minimized by locating the incision in natural anatomical boundaries like nipple areolar border, the infra mammary fold or axilla fossa. In this work, we assessed the use of lateral sulcus mammoplasty as a new oncoplastic technique for laterally located breast cancer as regards feasibility, complications and aesthetic outcome. This prospective study was carried out at the Department of Surgery, Faculty of Medicine, Menofiya University and Insurance Hospital in Tanta. A total of 77 female patients with laterally located breast cancer and indicated to oncoplastic breast surgery (OBS) were enrolled into the study All our patients were operated in supine position. Age of patients ranged from 30 to 53 years with mean of 41.14 years. Larger percentage of patients had painless lump in upper outer quadrant (81.8%) and 59.7% had right side lesion. Tumor size ranged from 1.0 to 3.0 cm with mean 2.02 cm with The average specimen weight was 78.25 ± 14.73 gm. Twelve patients received in neoadjuvant chemotherapy (15.6%). Regarding core biopsy, 83.1% had invasive duct carcinoma while postoperative pathology showed that 83.1% had invasive duct carcinoma. larger percentage had stage II (84.4%). |