ONCOPLASTIC RESECTION IN BREAST CANCER TREATMENT
The choice of the reduction mammoplasty method and the nipple-areolar complex (NAC) pedicle depending on the optimum blood supply and the cancer location in a breast is described in this article. Objective. to improve aesthetic outcomes of the breast cancer (BC) treatment without the oncological safety decrease. Material and methods. The study involved 30 patients from 36 to 55 years old with T1-T2 BC without BRCA1, BRCA2, CHEK2 mutations, who underwent the reduction mammoplasty with NAC preservation on a pedicle: the D. C. Hammond’s SPAIR mammoplasty was used for tumors in the superior and lateral breast areas, the combined vertical mammoplasty according to the C. Lassus, F. Lista, B. Strauch patterns was used for tumors in the inferior and medial areas. NAC was preserved on the pedicle opposite the tumor. The contralateral breast symmetry and the intraoperative investigation of surgical margins were performed. The outcomes were evaluated by three aesthetic criteria: the conical breast shape obtaining, the NAC positioning at the breast apex, the NAC positioning above the inframammary fold level, or the positioning at the mid-shoulder level. As a result, 20 patients have undergone the D.C. Hammond’s SPAIR mammoplasty with the inferomedial NAC pedicle. The combined vertical mammoplasty was performed in 10 patients. In 8 of them the superomedial NAC pedicle was used, in 2 patients the vertical pedicle was used and the cut rotation caused by the tumors in the inferomedial breast quadrant was performed. The aesthetic criteria were achieved and surgical margins were negative in all cases. Conclusions. The proposed approach gives the possibility to remove large volume of breast tissue, a short scar on the skin and the excellent aesthetic postoperative outcomes without the oncological safety decrease in the BC treatment, that allow to use it to resect tumors of any location, except the ones of the superficial location in the superior poles, where the lost volume needs to be replenished by other tissues, or implants.
Keywords
necrosis prevention,
nipple preservation,
NAC pedicle,
breast cancer,
reduction mammoplasty,
oncoplastic surgery,
предотвращение некроза,
ножка САК,
сохранение соска,
редукционная маммопластика,
онкопластика,
рак молочной железыAuthors
| Egorov Yu.S. | | |
| Dzottsoev A.K. | | ardzot@gmail.com |
Всего: 2
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