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| J Korean Med Assoc > Volume 52(10); 2009 > Article |
Abstract
For the majority of patients with breast cancer, a surgery that minimizes breast loss combined with radiotherapy has become a popular treatment of choice. The wider clearance margins are necessary for the lower risk of local recurrences, although the greater amount of breast tissue should be removed and the risk of deformation of the breast is higher. Satisfactory cosmetic results can be achieved by oncoplastic breast surgery. The aims of this paper are to review articles of oncoplastic surgery for breast cancer and to summarize the full range of immediate reconstructions from local flaps to sophisticated perforator flaps. It is important for a surgeon to minimize breast loss while the operation and maintain the patient's feeling that her breasts are still a part of her own body after the operation. The oncoplastic breast surgery will become an integral element of the surgical treatment of breast cancer in the future.
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Figure 1A
Preoperative view of a 51-year-old patient suffering symptomatic macromastia with invasive carcinoma in the upper outer quadrnat of the right breast and the ductal carcinoma in situ in the upper outer quadrant of left breast.
Figure 1B
Intraoperative view showing the completion of bilateral breast reduction with a Wise-pattern inferior pedicle technique.
Figure 1C
The aesthetic outcome of bilateral breast reduction with a Wise-pattern inferior pedicle technique.
Figure 2A
Preoperative view of the left breast with a tumor located at lower pole of left breast (Lt.) and close-up view (Rt.).
Figure 2C
Intraoperative view showing rotation of thoracoepigastric flap into the defect of lower pole of left breast after partial mastectomy.
Figure 2D
View of showing skin closure and a complete reconstruction by rotation of thoracoepigastric flap.
Figure 3A
Preoperative view of rotational flap designed to perform a wide excision and transfer subaxillary skin and subcutaneous fat into the upper outer quadrant.
Figure 4A
Preoperative view showing a patient with a mass located in the upper outer quadrant of right breast and planned for partial mastectomy and repairing of the defect with a superiorly based local flap.
Figure 4B
Intraoperative view showing a partial mastectomy and incision of superiorly based local flap.
Figure 4C
Immediate postoperative view showing skin closure and completion of superiorly based local flap.
Figure 5A
Preoperative view of a 44-year-old patient with invasive ductal carcinoma in the mid-upper quadrant of right breast.
Figure 5B
A view showing a mass located in the mid-upper quadrant of right breast and the planned for partial mastectomy and repairing of the defect with a inferiorly based local flap.
Figure 5C
Intraoperative view showing a partial mastectomy defect and incision of inferiorly based local flap.
Figure 5D
Immediate postoperative view showing skin closure and completion of inferiorly based local flap.
Figure 6A
A patient with a mass located in transition zone of the upper and lower outer quadrants of the left breast. A partial mastectomy and lateral thoracodorsal fasciocutaneous flap was designed.
Figure 6B
A intraoperative view of the lateral thoracodorsal fasciocutaneous flap dissected and rotated into the lateral breast defect.
Figure 6C
Immediate postoperative view showing skin closure and completed reconstruction by a rotation of lateral thoracodorsal fasciocutaneous flap.
Figure 7A
Preoperative view of patient with ductal carcinoma in situ in the upper and lower outer quadrants of left breast with diffuse microcalcification.
Figure 7C
The nipple was inverted by index finger and the milk ducts were exposed. After cutting the milk ducts with tips of Mezenbaum scissors, the tissue was sent for frozen section. This procedure was repeated to expose the clear margin of nipple-areolar complex.
Figure 7D
Intraoperative view by transillumination with the dissected skin flap containing subcutaneous fat and superficial fascia of the gland to avoid any breast parenchyma remained on the skin flap.
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