Downloaded 217 times
Uploaded byKundan Singh
Oncoplastic breast surgery
Oncoplastic breast surgery combines lumpectomy with reconstructive techniques to achieve local control and aesthetic improvements post-surgery. The classification of breast defects helps guide treatment approaches, balancing the benefits of wider excisions and improved cosmetic outcomes against factors such as the need for specialized teams and potential delays in treatment. Key techniques include various types of flaps and grafts tailored to each patient's specific needs, focusing on individual reconstructive requirements.
More Related Content
Similar to Oncoplastic breast surgery
Oncoplastic breast surgery
- 1. Oncoplastic breast surgery: indications,techniques and perspectives Dr Kundan Department of Surgical oncology Mahavir Cancer Sansthan , Patna
- 2. Alexandre Mendonça Munhoz •Simultaneous application of lumpectomy and reconstructive techniques • local control with wider excision without compromising oncologic principles • provides esthetic closure of the formed glandular defect by plastic techniques.
- 3.
- 4. Why oncoplasty Clough etal. classified the breast defects of BCS • Type-I breast deformity have a normal-appearing breast with no deformity. However, there is asymmetry in the volume or shape between breasts and were managed by a contralateral breast surgery. • Type-II patients have deformed breasts, however, is treated by an ipsilateral breast surgery or flap reconstruction. • Type-III patients have either major deformity with fibrosis and were treated with total mastectomy and reconstruction.
- 5. Oncoplastic Surgery Pros • Widerexcisions - Better margins • Less recurrences • Overall better cosmetic outcomes Cons • Trained teams • Higher cost • Possible delay of adjuvant treatments
- 6. Timing : -When to do ? Immediate 1. The surgical process is smooth since oncological and reconstructive surgery can be associated in one operative setting. 2. There is no scar and fibrosis tissue, breast reshaping is easier, and the aesthetic is improved
- 7. Basic principle • Patientselection ( criteria same as BCS ) • Evaluation ( As per BCS ) • Treatment planning • Resection with adequate marking • Intraop pathological evaluation ( Frozen Section ) • Marking Resection cavity ( for future RT planning ) • Intra op RT ( if available ) • ALND / SLNB • Oncoplastic repair • Adjuvant chemotherapy followed by RT ( IMRT )
- 8. • Surgical planningshould include the breast volume, tumor location, the extent of glandular tissue resected, and chiefly addressing individual reconstructive requirements, enabling each patient to receive an individual “custom made” reconstruction.
- 9. Which technique touse for each case? • Breast tissue advancement flaps (BAF) • Fat grafting • Mastopexy • Breast Reduction mammaplasty (BRM), • Latissimus dorsi myocutaneous flap (LDMF) • Lateral Thoracodorsal Flap (LTDF) • Lateral Intercostal Artery Perforator Flap • TRAM / DIEP • Occult TRAM
- 10. • Level 1-simple closure for less than 20 % volume loss • Level 2 – Volume displacement – 20-50 % volume loss Volume replacement > 50 % volume loss
- 13. • Basic Cruxis Elevation of NAC Scars to be lower segment / outer side
- 14.
- 15.
- 16.
- 17. OPBS with NACrecon
- 18.
- 19.
- 20.
- 21.