Oncoplastic Breast Surgery after Neoadjuvant Chemotherapy Replacing Mastectomy in Locally Advanced Breast Cancer (LABC): Single Institute Experience — Oak Academic Publishing
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Oncoplastic Breast Surgery after Neoadjuvant Chemotherapy Replacing Mastectomy in Locally Advanced Breast Cancer (LABC): Single Institute Experience
General Surgery Department, Ain Shams University, Cairo, Egypt
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General Surgery Department, Ain Shams University, Cairo, Egypt
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General Surgery Department, Ain Shams University, Cairo, Egypt
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Clinical Oncology Department, Ain Shams University, Cairo, Egypt
1 General Surgery Department, Ain Shams University, Cairo, Egypt
2 General Surgery Department, Ain Shams University, Cairo, Egypt
3 General Surgery Department, Ain Shams University, Cairo, Egypt
4 Clinical Oncology Department, Ain Shams University, Cairo, Egypt
Background: Integration of neoadj u vant chemotherapy (NCT) in early 70s resulted that many LABC tumors become resectable but with total mastectomy especially those with partial response, oncoplastic techniques give better oncological outcome with better cosmetic results. Objective: We evaluate the oncological safety of oncoplastic breast surgery (OS) in LABC showing partial response to NCT. Methods: We prospectively analyzed the data of 32 out of 58 patients with LABC who showed partial response to NCT and could have conservative surgery with advanced oncopla s tic techniques rather than total mas tectomy. Results: Out of 58 patients with LABC, received neoadjuvant che motherapy, complete response was observed in 8 patients (13%), partial response reported in 32 (55.1%) cases, 12 patients (20%) had stable disease and 6 patients (10%) showed progressive disease. Data of 32 cases were studied (mean age 44.84 ± 9.10 years; range 26 - 59 years). Inferior pedicle was performed in 9 cases, mini LD flap in 3 patients, 5 had Grissotti technique, 6 with super o medial pedicle, 4 had V mammoplasty and 3 with J mammoplasty and 2 had vertical mammoplasty. Margins were positive in 5 cases (15.6%) with mean mar gin width 9.63 ± 5.72 (range 0 - 22 mm), and the local recurrence was re ported in 2 cases (6.2%). Complications were reported in 3 cases (9.3%) . The follow up was 1.67 ± 1.03 (range 0 - 3.3 years). Conclusions: Integration of neoadj u vant chemotherapy together with advanced oncoplastic techniques open s a new way for management of LABC especially those showing partial response with avoidance of total mastectomy, and comparable oncological safety in addition to better aesthetic and psychological outcome.
KeywordsLocally Advanced Breast CancerOncoplastic SurgeryOncological SafetyNeoadjuvant Chemotherapy
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