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Article Type

Original Study

Abstract

Objective To assess different techniques of oncoplastic breast-conserving surgery, according to breast shape, protrusion, size, and symmetry. Background Oncoplastic surgery has emerged as a new approach to allow wide excision for breast-conserving surgery without compromising the natural shape of the breast. It is based on integration of plastic surgery techniques for immediate breast reshaping after wide excision for breast cancer. Patients and methods This prospective study was carried out on 35 patients; all patients had breast tumor and were being managed at Menoufia University Hospitals by different modalities of oncoplastic breast surgery during the period from April 2012 to December 2013. The appropriate oncoplastic technique was selected for every patient taking into consideration the location and size of the mass and breast size and ptosis. Results Seven patients underwent simple oncoplastic procedures with volume displacement techniques, 20 patients underwent more advanced oncoplastic techniques of volume replacement with local dermoglandular flaps, and eight patients required reconstruction with distant pedicle musculocutaneous flaps. All our patients had negative clear specimen margins. Only three complications were encountered: one case of skin necrosis in the skin envelope after skin-sparing mastectomy and two cases of traumatic fat necrosis with the inverted-T technique. Conclusion This study showed that creative use of reconstructive techniques can yield excellent results, fulfilling all patient and surgeon expectations with a minimum rate of morbidity. Younger women with a small-size breast will benefit from a simple oncoplastic technique with volume displacement procedures. Women with large ptotic breasts need more complex mammoplastic techniques with or without flaps. Oncoplastic surgery should be the standard approach to breast cancer treatment whenever feasible.

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