THE PERSPECTIVES FOR BREAST CONSERVATION SURGERY (BCS)

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ONCOPLASTIC BREAST SURGERY OR THE PERSPECTIVES FOR BREAST-CONSERVATION SURGERY (BCS)

Breast-conservation surgery (BCS) and Oncoplastic breast surgery is a safe option for most female with early breast cancer.  

Yes, its recently, innovations in stream of oncoplastic techniques that have aided the cancer patients with reduced surgical trauma and a conservative approach that again is capable of preserving the breast. 

In spite of the most apt managing options of primary closure, the oncoplastic breast surgery or BCS defects are encountered with the aesthetic outcome – that may be unpredictable.  

In this lieu the oncology team of patient approaches the arm of Oncoplastic reconstruction. The oncoplastic reconstruction can itself be begin at the time of BCS (immediate). Or oncoplastic surgery can also be followed by oncoplastic reconstitution that is done in weeks (delayed-immediate) or months to years afterwards (delayed).  

It is essential here to mention that in the cases where immediate reconstruction is done, the surgical process is smooth as the steps are associated in one operative setting.  

As per the data reported by best oncologists offering best breast cancer treatment in India enlist that the 5-year survival of BCS with radiation is not statistically different in contrast to mastectomy offered alone as conventional treatment in patients with Stage I or II breast cancer. 

Statistical scoops also alarm that about 10% to 30% of patients submitted to BCS are not satisfied with the aesthetic outcome that include the clinical aspects related to skin pigmentation changes, telangiectasia, and skin fibrosis. In the glandular tissue, local radiation causes fibrosis and retraction. 

Talking about the raising attention to oncoplastic procedures – that offers the immediate application of plastic breast surgery techniques that provide a wider local excision allows to achieve the goals of a better breast shape and symmetry  

It is well accepted that oncoplastic breast surgery referred as the modern oncoplastic breast surgery combines principles of oncologic and plastic surgery techniques. This combination of principles of oncology and plastic surgery allowed the doctors to obtain oncologic ally sound and aesthetically pleasing results.  

What the oncoplastic techniques are related to? – the oncoplastic technique are related to volume displacement or replacement procedures.  

Yes, oncoplastic approach can be started at the time of BCS (immediate), weeks (delayed-immediate) or months to years afterwards (delayed) as well. The main advantages of the technique utilized should include reproducibility and patient satisfaction.  

This surely includes the main goal of low interference with the oncologic treatment and long-term results.  

Another aspect of oncoplastic breast surgery being preferred is the possibility of accomplishing negative resection margin. As the immediate reconstruction allows for wider local tumor excision, potentially reducing the incidence of margin involvement and this idea emphasize on permitting larger resections, with a superior mean volume of the specimen and negative margins. 

Possibly an ideal procedure or recommended guidelines does not exist and each case should be planned individually. As any surgical technique, all these goals are probably not met by any single procedure as each case with individual technique presents particular advantages for their indications, tumor location limitations, vascular pedicle, additional skin and glandular resections due to compromised margins, and resultant scar.  

Clinical results of oncoplastic breast surgery- are better and we also cannot neglect that immediate BCS reconstruction is challenging for oncological and plastic surgeons. The data recently supports that the oncoplastic approach associated with BCS can be considered as safe as mastectomy in tumours less than 2 cm and possibly safer than the BCS.  Another important issue in limitations associated is related to the complication rates and the timing of reconstruction; as in BCS with delayed reconstruction complication rates have been shown to be higher than immediate reconstruction. 

For more details and second opinion on breast cancer treatment – please contact Cancer Rounds. 

Posted by, magneto
February 3, 2022

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