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Daoud A, Vignaroli KA, Malkoc A, Mamoun L, Cerceo JR, Perez K, Guan A, Kim SU, Barmanwalla A, Ramiscal JAB. Oncoplastic Breast-Conserving Surgery Outcomes in the Hispanic Population at a Large County Hospital. Cureus 2025; 17:e79932. [PMID: 40182375 PMCID: PMC11966340 DOI: 10.7759/cureus.79932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2025] [Indexed: 04/05/2025] Open
Abstract
OBJECTIVES Compared to standard breast-conserving surgery (BCS), oncoplastic breast-conserving surgery (OBCS) allows for improved tumor exposure and higher volume tissue resection. OBCS also has lower rates of tumor recurrence and need for re-resection, superior cosmetic outcomes, improved patient satisfaction, and decreased postoperative breast volume, leading to lower doses of postoperative radiotherapy. Additionally, OBCS has no difference in postoperative complications or overall survival compared to BCS. While widespread use of OBCS has increased, racial disparities continue to exist in the utilization of OBCS, and there is little research investigating how race affects OBCS outcomes. To that end, our study aimed to compare outcomes between Hispanic and non-Hispanic patients undergoing OBCS at a large county hospital. METHODS A retrospective review was performed of adult patients who underwent OBCS at a county hospital in Southern California. Subjects were divided into Hispanic and non-Hispanic groups, and the primary outcomes included the need for re-excision, hematoma or seroma formation, wound infection, areolar loss, skin necrosis, and delayed wound healing. RESULTS The Hispanic group had a lower rate of delayed wound healing (p=0.022). Otherwise, there were no significant differences in demographics or outcomes between the two populations, including the need for re-excision, hematoma or seroma formation, wound infection, areolar loss, and skin necrosis. CONCLUSION OBCS is a valuable option when considering reconstruction for lumpectomy in Hispanic populations. The benefits of OBCS should not be understated and should be considered for all patients who are appropriate candidates.
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Affiliation(s)
- Amanda Daoud
- General Surgery, Arrowhead Regional Medical Center, Colton, USA
| | | | - Aldin Malkoc
- General Surgery, Arrowhead Regional Medical Center, Colton, USA
| | - Lana Mamoun
- General Surgery, Arrowhead Regional Medical Center, Colton, USA
| | - Jaclyn R Cerceo
- General Surgery, Arrowhead Regional Medical Center, Colton, USA
| | - Kevin Perez
- General Surgery, Arrowhead Regional Medical Center, Colton, USA
| | - Angel Guan
- General Surgery, Arrowhead Regional Medical Center, Colton, USA
| | - So Un Kim
- General Surgery, Arrowhead Regional Medical Center, Colton, USA
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2
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Lee A, Kwasnicki RM, Khan H, Grant Y, Chan A, Fanshawe AEE, Leff DR. Outcome reporting in therapeutic mammaplasty: a systematic review. BJS Open 2021; 5:zrab126. [PMID: 34894122 PMCID: PMC8665419 DOI: 10.1093/bjsopen/zrab126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 11/05/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Therapeutic mammaplasty (TM) is an oncological procedure which combines tumour resection with breast reduction and mastopexy techniques. Previous systematic reviews have demonstrated the oncological safety of TM but reporting of critically important outcomes, such as quality of life, aesthetic and functional outcomes, are limited, piecemeal or inconsistent. This systematic review aimed to identify all outcomes reported in clinical studies of TM to facilitate development of a core outcome set. METHODS Medline, EMBASE, CINAHL and Web of Science were searched from inception to 5 August 2020. Included studies reported clinical outcomes following TM for adult women. Two authors screened articles independently for eligibility. Data were extracted regarding the outcome definition and classification type (for example, oncological, quality of life, etc.), time of outcome reporting and measurement tools. RESULTS Of 5709 de-duplicated records, 148 were included in the narrative synthesis. The majority of studies (n = 102, 68.9 per cent) reported measures of survival and/or recurrence; approximately three-quarters (n = 75, 73.5 per cent) had less than 5 years follow-up. Aesthetic outcome was reported in half of studies (n = 75, 50.7 per cent) using mainly subjective, non-validated measurement tools. The time point at which aesthetic assessment was conducted was highly variable, and only defined in 48 (64.0 per cent) studies and none included a preoperative baseline for comparison. Few studies reported quality of life (n = 30, 20.3 per cent), functional outcomes (n = 5, 3.4 per cent) or resource use (n = 28, 18.9 per cent). CONCLUSION Given the oncological equivalence of TM and mastectomy, treatment decisions are often driven by aesthetic and functional outcomes, which are infrequently and inconsistently reported with non-validated measurement tools.
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Affiliation(s)
- Alice Lee
- Department of Surgery and Cancer, Imperial College London, London, UK
| | | | - Hasaan Khan
- Faculty of Medicine, Imperial College London, London, UK
| | - Yasmin Grant
- Department of BioSurgery, Imperial College London, London, UK
| | - Abigail Chan
- Faculty of Medicine, Imperial College London, London, UK
| | - Angela E E Fanshawe
- Department of Breast Surgery, Charing Cross Hospital, Imperial College NHS Trust, London, UK
| | - Daniel R Leff
- Department of Surgery and Cancer, Imperial College London, London, UK
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3
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Shi W, Torres-de la Roche LA, Ritter H, Dong J, Zeng JJ, Jiang YC, Zhuo R, De Wilde RL. An innovative oncoplastic technique for immediate small to medium volume breast reconstruction in lower inner quadrant cancer: The Zhuo-technique. Ann Med Surg (Lond) 2021; 68:102576. [PMID: 34367636 PMCID: PMC8326341 DOI: 10.1016/j.amsu.2021.102576] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Insufficient glandular tissue in the lower quadrant of the breast is the main source of difficulty in repairing defects after oncoplastic surgery. Especially in small to medium sized breasts, this issue is more common. Here, we describe a novel oncoplastic approach that could help to solve this problem. MATERIALS AND METHODS Retrospective analysis of breast cancer patients with tumors in the lower inner quadrants, who underwent Zhuo's technique between January 2017 and August 2019. Aesthetic outcomes were evaluated in terms of the Paris Breast Center's 5-point scale. The work was reported according to the STROCSS criteria. RESULTS Nine patients (mean age 54 years) with small to medium volume breast received Zhuo's oncoplastic technique after tumor excision. The mean size tumor was 18.0 mm. The median follow-up time was 27.0 months. Sentinel lymph node biopsy results for all patients were negative. None of the patients had local recurrences or metastases and postoperative complications were not observed. Seven patients (77.8%) achieved aesthetic scores of 5 and two patients (22.2%) achieved 4 points. CONCLUSIONS Zhuo's oncoplastic technique could provide a favorable and flexible surgical approach for small to medium volume breast with tumors of the lower inner quadrant with a low risk of recurrence and good aesthetic results. PROTOCOL REGISTER Chinese clinical trial register No. ChiCTR2100043484.
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Affiliation(s)
- Wenjie Shi
- University Hospital for Gynecology, Pius-Hospital, University Medicine Oldenburg, 26121, Oldenburg, Germany
| | | | - Henning Ritter
- Director Sino-European Brest Care Nurse School in Guilin, PR China
| | - Jie Dong
- Department of Breast Surgery, EUSOMA Certified Breast Center, Guilin TCM Hospital of China, Guilin, 541002, Guang Xi, PR China
| | - Jia-Jia Zeng
- Department of Breast Surgery, EUSOMA Certified Breast Center, Guilin TCM Hospital of China, Guilin, 541002, Guang Xi, PR China
| | - Yi-Cheng Jiang
- Department of Breast Surgery, EUSOMA Certified Breast Center, Guilin TCM Hospital of China, Guilin, 541002, Guang Xi, PR China
| | - Rui Zhuo
- Department of Breast Surgery, EUSOMA Certified Breast Center, Guilin TCM Hospital of China, Guilin, 541002, Guang Xi, PR China
| | - Rudy Leon De Wilde
- University Hospital for Gynecology, Pius-Hospital, University Medicine Oldenburg, 26121, Oldenburg, Germany
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4
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Lee A, Kwasnicki RM, Leff DR. Outcomes and outcome measures reported in clinical studies of therapeutic mammaplasty: a systematic review protocol. BMJ Open 2021; 11:e046438. [PMID: 34135045 PMCID: PMC8211071 DOI: 10.1136/bmjopen-2020-046438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 06/09/2021] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Therapeutic mammaplasty (TM) is an oncological procedure which combines tumour resection with breast reduction and mastopexy techniques. Previous systematic reviews have demonstrated oncological safety of TM, but poor and inconsistent reporting of quality-of-life, aesthetic and functional outcomes, often with non-validated measurement tools. Moreover, there is a paucity of patient-reported outcome measures. Standardisation of outcome reporting is required to enable study results to be compared and combined, for example, through core outcome set (COS) development. This systematic review aims to comprehensively describe the outcomes reported in clinical studies of TM, their respective outcome measures and the time points at which they were evaluated. The overall objective is to facilitate the development of a COS for TM. METHODS AND ANALYSIS A systematic review of clinical studies evaluating outcomes following TM will be completed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The following electronic databases have been searched from inception to 5 August 2020: Ovid MEDLINE, Embase, CINAHL and Web of Science. Primary outcomes will include the number of reported outcomes of various types (clinical, aesthetic, functional, quality-of-life and cost-effectiveness), whether these are patient-reported or clinician-reported, how outcomes are defined and the outcome measurement tool(s) used. The time point(s) at which outcomes were measured will be a secondary outcome. No studies will be excluded on the basis of methodological quality in order to generate a comprehensive list of reported outcomes and outcome measures; hence, risk of bias assessment is not required. The data will be described narratively. This protocol has been reported in line with PRISMA-Protocols. ETHICS AND DISSEMINATION This study does not involve human or animal participants, hence ethical approval is not required. The findings will be published in a peer-reviewed journal and presented at relevant conferences. PROSPERO REGISTRATION NUMBER CRD42020200365.
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Affiliation(s)
- Alice Lee
- Department of Surgery and Cancer, Imperial College London, London, UK
| | | | - Daniel R Leff
- Department of Surgery and Cancer, Imperial College London, London, UK
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5
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Savioli F, Seth S, Morrow E, Doughty J, Stallard S, Malyon A, Romics L. Extreme Oncoplasty: Breast Conservation in Patients with Large, Multifocal, and Multicentric Breast Cancer. BREAST CANCER (DOVE MEDICAL PRESS) 2021; 13:353-359. [PMID: 34079367 PMCID: PMC8164874 DOI: 10.2147/bctt.s296242] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/22/2021] [Indexed: 12/02/2022]
Abstract
INTRODUCTION Extreme Oncoplastic Breast Conservation Surgery (EOBCS) is offered in selected patients with multifocal or multicentric breast cancer (MFMC). Recent evidence has suggested that EOBCS may be a valuable resource for patients with MFMC who may avoid the risk associated with mastectomy in favour of the benefits of breast conservation without risking their oncological outcomes. Our study examined the practice of EOBCS in two regional breast units in Glasgow, United Kingdom. MATERIALS AND METHODS A prospectively collected database of 50 patients treated with EOBC in two breast units in Glasgow between 2007 and 2018 were evaluated, and clinical outcomes were observed. RESULTS Fifty patients (median age 55) underwent EOBCS, of which 43 (86%) had invasive disease. Median tumour size was 55mm (50-90) and multifocal disease was identified in 22 (44%) patients. Nine patients (18%) were found to have positive margins and underwent a second procedure, with 6 (12%) proceeding to mastectomy. Five-year disease free survival rate was 91.5%, while cancer-specific survival was 95.7%. CONCLUSION EOBCS is oncologically safe in short-term follow-up. Large scale studies are required to confirm these preliminary results, in order to offer EOBCS as a valid option to patients with advanced or multifocal breast cancer.
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Affiliation(s)
- Francesca Savioli
- Academic Unit of Surgery, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
| | - Subodh Seth
- Department of Breast Surgery, Forth Valley Royal Hospital, Larbert, UK
| | - Elizabeth Morrow
- Academic Unit of Surgery, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
| | - Julie Doughty
- Department of Breast Surgery, Gartnavel General Hospital, Glasgow, UK
| | - Sheila Stallard
- Department of Breast Surgery, Gartnavel General Hospital, Glasgow, UK
| | - Andy Malyon
- Canniesburn Department of Plastic Surgery, Glasgow Royal Infirmary, Glasgow, UK
| | - Laszlo Romics
- Academic Unit of Surgery, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
- Department of Breast Surgery, New Victoria Hospital, Glasgow, UK
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Manie TM, Youssef MMG, Taha SN, Rabea A, Farahat AM. Batwing mammoplasty: a safe oncoplastic technique for breast conservation in breast cancer patients with gigantomastia. Ann R Coll Surg Engl 2020; 102:115-119. [PMID: 31538808 PMCID: PMC6996419 DOI: 10.1308/rcsann.2019.0129] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Surgical management of breast cancer with gigantomastia can be challenging when planning breast conservation, as major breast reduction is required. Complex oncoplastic procedures can carry an additional surgical risk in this situation. We suggest batwing mammoplasty as a simple and safe oncoplastic procedure for those patients. MATERIALS AND METHODS Fourteen patients with gigantomastia diagnosed with breast cancer were included in this prospective cohort study. All underwent batwing mammoplasty and contralateral symmetrisation procedure between May 2016 and June 2018. Patient satisfaction assessed by the Breast-Q questionnaire. RESULTS All patients had a body mass index above 30kg/m2 with a mean of 36.7kg/m2 (range 31.6-44.9kg/m2). The mean distance from midclavicular point to nipple was 42cm (range 38-50cm). The mean operative time was 83 minutes for procedures done by a single surgeon. Mean specimen weight was 1.2kg (ranging from 1.035-1.63kg). Postoperative complications occurred in 14.2% of patients. Nipple-areola complex viability was not compromised nor sensation impaired. The mean Breast-Q score for patient satisfaction with breasts was 68.6 (range 61-74). The mean score for physiological wellbeing was 77.3 (range 64-84) and the mean score for physical wellbeing was 35 (range 31-40). CONCLUSION Batwing mammoplasty is a safe and simple oncoplastic procedure in patients who have breast cancer with gigantomastia. It has short operative time and low complications rate. In our cohort of patients, there was no delay in the delivery of adjuvant treatment. The cosmetic outcome was favourable with a high patient satisfaction.
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Affiliation(s)
- TM Manie
- Breast Surgery Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - MMG Youssef
- Breast Surgery Department, National Cancer Institute, Cairo University, Cairo, Egypt
- Breast Surgery Department, Norfolk and Norwich University Hospital, Norwich, UK
| | - SN Taha
- Breast Surgery Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - A Rabea
- Medical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - AM Farahat
- Breast Surgery Department, National Cancer Institute, Cairo University, Cairo, Egypt
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7
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Extreme Oncoplastic Surgery for Multifocal/Multicentric and Locally Advanced Breast Cancer. Int J Breast Cancer 2019; 2019:4262589. [PMID: 30915240 PMCID: PMC6402217 DOI: 10.1155/2019/4262589] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 12/27/2018] [Indexed: 12/11/2022] Open
Abstract
Introduction Breast conserving surgery (BCS) followed by radiation therapy (RT) has become the preferred alternative to mastectomy for patients with early stage breast cancer (BC). Randomized trials have confirmed equivalent locoregional control and overall survival for BCS and mastectomy. Extreme Oncoplasty (EO) extends the indications of BCS for patients who would otherwise require mastectomy, ensuring better aesthetic outcomes and oncological safety. Methods BC patients with multifocal/multicentric (MF/MC) tumors, extensive DCIS, or large tumor >50mm underwent EO at our breast unit. Therapeutic reduction mammaplasty (TRM) with wise pattern preoperative markings and dual pedicle technique involving parenchymal rearrangement was used for oncoplastic reconstructions in majority of the cases followed by RT. Patient reported outcome measures (PROMs) were assessed using the validated Breast-Q questionnaire. Results Of the 39 patients in the study, 36 had unilateral and 3 had bilateral BC. Mean age was 47.2 years. Median tumor size was 75mm. 17 (43.6%) patients received NACT; none achieved a complete clinical response. 28 (71.8%) patients were administered to adjuvant chemotherapy. 33(84.6%) patients received RT to the breast with a median dose of 50Gy in 28 fractions and a boost dose of 10Gy in 5 fractions to the tumor bed. No major complications or local recurrences were observed. Excellent Breast-Q scores were observed in patients undergoing EO after 12 months of follow-up. Conclusion EO followed by RT results in acceptable local-regional control, low rate of complications, and high patient satisfaction. In selected patients, EO could provide a safe alternative for breast conservation surgery instead of mastectomy.
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8
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Chatterjee A, Dayicioglu D, Khakpour N, Czerniecki BJ. Oncoplastic Surgery: Keeping It Simple With 5 Essential Volume Displacement Techniques for Breast Conservation in a Patient With Moderate- to Large-Sized Breasts. Cancer Control 2018; 24:1073274817729043. [PMID: 28975837 PMCID: PMC5937235 DOI: 10.1177/1073274817729043] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Oncoplastic surgery is an evolving field in breast surgery combining the strengths of breast surgical oncology with plastic surgery. It provides the surgeon the ability to excise large areas of the breast in the oncologic resection without compromising, and possibly improving, its aesthetic appearance. The purpose of this review is to provide a guide that could help a breast surgeon excise breast cancer in most areas of the breast using 5 oncoplastic techniques. These techniques would be used depending primarily on the location of the cancer in the breast and also on the size of the tumor.
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Affiliation(s)
- Abhishek Chatterjee
- 1 Division of Surgical Oncology and Plastic Surgery, Tufts Medical Center, Boston, MA, USA
| | - Deniz Dayicioglu
- 2 Department of Breast Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA.,3 Department of Plastic Surgery, University of South Florida, Tampa, FL, USA
| | - Nazanin Khakpour
- 2 Department of Breast Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Brian J Czerniecki
- 2 Department of Breast Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
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9
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Yoon JJ, Green WR, Kim S, Kearney T, Haffty BG, Eladoumikdachi F, Goyal S. Oncoplastic breast surgery in the setting of breast-conserving therapy: A systematic review. Adv Radiat Oncol 2016; 1:205-215. [PMID: 28740889 PMCID: PMC5514175 DOI: 10.1016/j.adro.2016.09.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 08/15/2016] [Accepted: 09/14/2016] [Indexed: 12/15/2022] Open
Abstract
Breast-conserving therapy (BCT), or breast-conserving surgery with adjuvant radiation therapy, has become a standard treatment alternative to mastectomy for women with early-stage breast cancer after many long-term studies have reported comparable rates of overall survival and local control. Oncoplastic breast surgery in the setting of BCT consists of various techniques that allow for an excision with a wider margin and a simultaneous enhancement of cosmetic sequelae, making it an ideal breast cancer surgery. Because of the parenchymal rearrangement that is routinely involved in oncoplastic techniques, however, the targeted tissue can be relocated, thus posing a challenge to localize the tumor bed for radiation planning. The goals of this systematic review are to address the challenges, outcomes, and cosmesis of oncoplastic breast surgery in the setting of BCT.
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Affiliation(s)
| | | | - Sinae Kim
- Biometrics Division, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Thomas Kearney
- Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Bruce G Haffty
- Department of Radiation Oncology, New Brunswick, New Jersey
| | - Firas Eladoumikdachi
- Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Sharad Goyal
- Department of Radiation Oncology, New Brunswick, New Jersey
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10
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Baker E, Kim B, Rattay T, Williams K, Ives C, Remoundos D, Holcombe C, Gardiner MD, Jain A, Sutton R, Achuthan R, Turton P, Fairbrother P, Brock L, Aggarwal S, Basu N, Murphy J, Trickey A, Macmillan RD, Potter S. The TeaM ( Th er apeutic Mammaplasty) study: Protocol for a prospective multi-centre cohort study to evaluate the practice and outcomes of therapeutic mammaplasty. Int J Surg Protoc 2016; 1:3-10. [PMID: 31851757 PMCID: PMC6913574 DOI: 10.1016/j.isjp.2016.08.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Revised: 08/20/2016] [Accepted: 08/20/2016] [Indexed: 11/15/2022] Open
Abstract
Multicentre prospective study involving breast and plastic surgical units across the UK. Will produce valuable data regarding the practice and outcomes of therapeutic mammaplasty. Will inform decision-making and lead to future definitive study. Will strengthen the collaborative network to facilitate the delivery of future projects. Will increase awareness of the techniques among trainees such that participation is educational.
Introduction Wide local excision and adjuvant radiotherapy is the standard of care for early breast cancer. For large tumours, however, mastectomy is frequently recommended as conventional breast-conserving techniques often result in poor cosmetic outcomes. Therapeutic mammaplasty (TM) may extend the boundaries of breast-conserving surgery by combining breast reduction and mastopexy techniques with tumour excision, preserving a natural breast shape and avoiding the need for mastectomy. The prevalence of this operative option among surgeons in the UK and its success rate are unknown. The TeaM study is a multicentre prospective study that aims to investigate the practice and outcomes of TM. Methods and analysis Breast centres performing TM will be invited to participate through the research collaborative network and the professional associations. All patients undergoing TM between September 2016 and March 2017 will be included. Demographic, operative, oncological and complication data within 30-days of surgery will be collected. The primary outcome will be unplanned re-operation for complications. Secondary outcomes will include unplanned readmission, re-excision rates and time to adjuvant therapy. Prospective data on 500 patients from 50 centres are anticipated. Exploratory analyses will identify predictors for complications and inform the design of a definitive study. Ethics and dissemination Research ethics approval is not required for this study. This has been confirmed by the on-line Health Research Authority decision tool. This study will provide novel information regarding the practice and outcomes of TM in the UK. This will inform decision-making for patients and surgeons and inform future research. Dissemination of the study protocol will be via the Mammary Fold Academic and Research Collaborative, the Reconstructive Surgery Trials Network and the professional associations, the Association of Breast Surgery and British Association of Plastic, Reconstructive and Aesthetic Surgeons. Results will be presented at relevant surgical conferences and published in peer-reviewed journals.
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Affiliation(s)
- Elizabeth Baker
- Breast Unit, Bradford Teaching Hospitals, Duckworth Lane, Bradford BD9 6RJ, UK
| | - Baek Kim
- Department of Breast Surgery, St. James's University Hospital, Beckett Street, Leeds LS9 7TF, UK
| | - Tim Rattay
- Department of Cancer Studies, Clinical Sciences Building, University of Leicester, Leicester LE2 2LX, UK
| | - Kathryn Williams
- Nightingale Breast Unit, University Hospital of South Manchester NHS Foundation Trust, Southmoor Road, Manchester M23 9LT, UK
| | - Charlotte Ives
- Torbay and South Devon NHS Foundation Trust, Newton Road, Torquay, Devon TQ2 7AA, UK
| | - Dennis Remoundos
- Oxford University Hospitals NHS Foundation Trust, Headley Way, Headington, Oxford OX3 9DU, UK
| | - Chris Holcombe
- Linda McCartney Centre, Royal Liverpool and Broadgreen University Hospital, Prescot Street, Liverpool L7 8XP, UK
| | - Matthew D Gardiner
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford OX3 7HE, UK.,Department of Surgery and Cancer, Imperial College London, SW7 2AZ, UK
| | - Abhilash Jain
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford OX3 7HE, UK.,Imperial College London NHS Trust, London SW7 2AZ, UK
| | - Richard Sutton
- Royal United Hospital NHS Foundation Trust, Combe Park, Bath, Avon BA1 3NG, UK
| | - Rajgopal Achuthan
- Breast Unit, Bradford Teaching Hospitals, Duckworth Lane, Bradford BD9 6RJ, UK
| | - Philip Turton
- Breast Unit, Bradford Teaching Hospitals, Duckworth Lane, Bradford BD9 6RJ, UK
| | | | - Lisa Brock
- Nottingham Breast Institute, Nottingham University Hospitals NHS Trust, Hucknall Road, Nottingham NG5 1PB, UK
| | - Shweta Aggarwal
- Whipps Cross University Hospital, Whipps Cross Road, Leytonstone, London E11 1NR, UK
| | - Naren Basu
- Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham B15 2TH, UK
| | - John Murphy
- Nightingale Breast Unit, University Hospital of South Manchester NHS Foundation Trust, Southmoor Road, Manchester M23 9LT, UK
| | - Adam Trickey
- Bristol Centre for Surgical Research, School of Social and Community Medicine, University of Bristol, 39 Whatley Road, Clifton, Bristol BS8 2PS, UK
| | - R Douglas Macmillan
- Nottingham Breast Institute, Nottingham University Hospitals NHS Trust, Hucknall Road, Nottingham NG5 1PB, UK
| | - Shelley Potter
- Bristol Centre for Surgical Research, School of Social and Community Medicine, University of Bristol, 39 Whatley Road, Clifton, Bristol BS8 2PS, UK
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11
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Pasta V, D’Orazi V, Merola R, Frusone F, Amabile MI, De Luca A, Buè R, Monti M. Oncoplastic central quadrantectomies. Gland Surg 2016; 5:422-426. [PMID: 27563564 PMCID: PMC4971343 DOI: 10.21037/gs.2016.04.01] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 04/11/2016] [Indexed: 12/28/2022]
Abstract
Tumors localized in the central quadrant (centrally located breast tumors) have always represented a challenge for the surgeon because of the critical aesthetical matters related to the nipple-areola complex (NAC). Many years of experience with breast cancer patients treated by using various oncoplastic techniques, has allowed us to develop the modified hemibatwing for the treatment of central breast tumors, where the NAC is involved. Modified hemibatwing-along with the removal of the NAC-is a useful oncoplastic technique and it represents an ideal option for the treatment of central tumors because it assures oncological safety, a reduced surgical timetable and greater aesthetical results.
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Affiliation(s)
- Vittorio Pasta
- Department of General Surgery, Policlinico Umberto I, University of Rome “La Sapienza”, Rome, Italy
- Department of Surgical Science, Policlinico Umberto I, University of Rome “La Sapienza”, Rome, Italy
| | - Valerio D’Orazi
- Department of General Microsurgery and Hand Surgery, Fabia Mater Hospital, I-00171 Rome, Italy
| | - Raffaele Merola
- Department of Surgical Science, Policlinico Umberto I, University of Rome “La Sapienza”, Rome, Italy
| | - Federico Frusone
- Department of Surgical Science, Policlinico Umberto I, University of Rome “La Sapienza”, Rome, Italy
| | - Maria Ida Amabile
- Department of Surgical Science, Policlinico Umberto I, University of Rome “La Sapienza”, Rome, Italy
| | - Alessandro De Luca
- Department of Surgical Science, Policlinico Umberto I, University of Rome “La Sapienza”, Rome, Italy
| | - Rosanna Buè
- Department of Surgical Science, Policlinico Umberto I, University of Rome “La Sapienza”, Rome, Italy
| | - Marco Monti
- Department of Gynecology and Obstetrics, Sapienza University of Rome, 00161 Rome, Italy
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