Oncoplastic breast surgery to prevent "Bird's beak" deformity in the breast: a comparative retrospective study.

Breast deformity Breast-conserving surgery Oncoplastic breast surgery Volume displacement

Journal

Surgery today
ISSN: 1436-2813
Titre abrégé: Surg Today
Pays: Japan
ID NLM: 9204360

Informations de publication

Date de publication:
08 May 2023
Historique:
received: 11 11 2022
accepted: 06 04 2023
medline: 9 5 2023
pubmed: 9 5 2023
entrez: 8 5 2023
Statut: aheadofprint

Résumé

Breast deformity occurring in the lower pole after breast conserving surgery (BCS) is known as bird's beak (BB) deformity. This retrospective study evaluated the outcomes in breasts reconstructed with a conventional closing procedure (CCP) and a downward-moving procedure (DMP), respectively, after BCS. In CCP, the inferomedial and inferolateral portions of breast tissues were reapproximated toward the midline after wide excision to repair the breast defect. In DMP, the retro-areolar breast tissue was detached from the nipple-areolar complex after wide excision, and the upper pole breast tissue was moved downward to refill the breast defect. CCP was performed in 20 patients (Group A), and DMP was performed in 28 patients (Group B). Although retraction of the lower part of the breast was postoperatively observed in 13 (72%) of 18 patients from Group A, it was observed in 7 (28%) of 25 patients in Group B (p < 0.05). The downward pointing of the nipple was observed in 8 (44%) of 18 patients from Group A and in 4 (16%) of 25 patients in Group B (p < 0.05). DMP is more useful for preventing BB deformity than CCP.

Identifiants

pubmed: 37157037
doi: 10.1007/s00595-023-02690-0
pii: 10.1007/s00595-023-02690-0
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2023. The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd.

Références

Clough KB, Cuminet J, Fitoussi A, Nos C, Mosseri V. Cosmetic sequalae after conservative treatment for breast cancer: classification and results of surgical correction. Ann Plast Surg. 1998;41:471–81.
doi: 10.1097/00000637-199811000-00004 pubmed: 9827948
Cochrane RA, Valasiadou P, Wilson ARM, Al-Ghazal SK, Macmillan RD. Cosmesis and satisfaction after breast-conserving surgery correlates with the percentage of breast volume excised. Br J Surg. 2003;90:1505–9.
doi: 10.1002/bjs.4344 pubmed: 14648728
Rainsbury RM. Surgery insight: oncoplastic breast-conserving reconstruction –indications, benefits, choices and outcomes. Nat Clin Pract Oncol. 2007;4(11):657–64.
doi: 10.1038/ncponc0957 pubmed: 17965643
Bulstrode NW, Shrotrica S. Prediction of cosmetic outcome following conservative breast surgery using breast volume measurements. Breast. 2001;10(2):124–6.
doi: 10.1054/brst.2000.0197 pubmed: 14965571
Clough KB, Kaufman GJ, Nos C, Buccimazza I, Sarfati IM. Improving breast cancer surgery: a classification and quadrant per quadrant atlas for oncoplastic surgery. Ann Surg Oncol. 2010;17(5):1375–91.
doi: 10.1245/s10434-009-0792-y pubmed: 20140531
Noguchi M, Yokoi-Noguchi M, Ohno Y, Morioka E, Nakano Y, Kosaka T, Kurita T. Oncoplastic breast conservative surgery: volume replacement vs. volume displacement. Eur J Surg Oncol. 2016;42(7):926–34.
doi: 10.1016/j.ejso.2016.02.248 pubmed: 26988623
Chatterjee A, Gass J, Patel K, Holmes D, Kopkash K, Peiris L, et al. A consensus definition and classification system of oncoplastic surgery developed by the American Society of Breast Surgeons. Ann Surg Oncol. 2019;26:3436–44.
doi: 10.1245/s10434-019-07345-4 pubmed: 30977016
Noguchi M, Ohno Y, Morioka E, Noguchi M, Nakano Y, Kosaka T, et al. A novel oncoplastic technique for breast cancer localized in the lower pole of the breast. J Surg Oncol. 2017;117:137–41.
doi: 10.1002/jso.24824 pubmed: 28940202
Noguchi M, Noguchi M, Ohno Y, Morioka E, Nakano Y, Kosaka T, et al. Feasibility study of axillary reverse mapping for patients with clinically node-negative breast cancer. Eur J Surg Oncol. 2016;42:650–6.
doi: 10.1016/j.ejso.2016.02.244 pubmed: 27005806
Moo TA, Choi L, Culpepper C, Olcese C, Heerdt A, Sclafani L, et al. Impact of margin assessment method on positive margin rate and total volume excised. Ann Sur Oncol. 2014;212:86–92.
doi: 10.1245/s10434-013-3257-2
Katariya RN, Forrest APM, Gravelle IH. Breast volumes in cancer of the breast. Br J Cancer. 1974;29:270–3.
doi: 10.1038/bjc.1974.66 pubmed: 4830145 pmcid: 2009093
Clough KB, Soussaline M, Campana F, Salmon RJ. Mammoplasty combined with irradiation: conservative treatment of breast cancer localized in the lower quadrant. Ann Chir Plast Esthet. 1990;35(2):117–22 (in French).
pubmed: 1696083
Noguchi M, Taniya T, Miyazaki I, Saito Y. Immediate transposition of a latissimus dorsi muscle for correcting a postquadrantectomy breast deformity in Japanese patients. Int Surg. 1990;75:166–70.
pubmed: 2242969
Noguchi M, Saito Y, Mizukami Y, Nonomura A, Ohta N, Koyasaki N, et al. Breast deformity, its correction, and assessment of breast conserving surgery. Breast Cancer Res Treat. 1991;18:111–8.
doi: 10.1007/BF01980973 pubmed: 1912608
Clough KB, Nos C, Salmon RJ, Soussaline M, Durand JC. Conservative treatment of breast cancers by mammaplasty and irradiation: a new approach to lower quadrant tumors. Plast Reconstr Surg. 1995;96(2):363–70.
doi: 10.1097/00006534-199508000-00015 pubmed: 7624409
Nos CN, Fitoussi A, Bourgeois D, Fourquet A, Salmon RJ, Clough KB. Conservative treatment of lower pole breast cancers by bilateral mammoplasty and radiotherapy. Eur J Surg Oncol. 1998;24:508–14.
doi: 10.1016/S0748-7983(98)93356-X pubmed: 9870725
Kronowitz S, Hunt KK, Kuerer HM, Strom EA, Buchholz TA, Ensor JE, et al. Practical guidelines for repair of partial mastectomy defects using the breast reduction technique in patients undergoing breast conservation therapy. Plast Reconstr Surg. 2007;120(7):1755–68.
doi: 10.1097/01.prs.0000287130.77835.f6 pubmed: 18090737
Ogawa T, Hanamura N, Yamashita M, Ri Y, Kuriyama N, Isaji S. Usefulness of breast-volume replacement using an inframammary adipofascial flap after breast-conserving therapy. Am J Surg. 2007;193:514–8.
doi: 10.1016/j.amjsurg.2006.07.018 pubmed: 17368302
Kijima Y, Yoshinaka H, Owaki T, Funasako Y, Aikou T. Immediate reconstruction using inframammary adipofascial flap of the anterior rectus sheath after partial mastectomy. Am J Surg. 2007;193(6):789–91.
doi: 10.1016/j.amjsurg.2006.06.052 pubmed: 17512298
Otsuka S, Watanabe N, Sasaki Y, Shimojima R. Postoperative courses of breast reconstruction using inferior adipofascial tissue repair. Breast Cancer. 2015;22(6):570–7.
doi: 10.1007/s12282-014-0522-6 pubmed: 24925523
Nakada H, Inoue M, Furuya K, Watanabe H, Ikegame K, Nakayama Y, et al. Fat necrosis after breast-conserving oncoplastic surgery. Breast Cancer. 2019;26:125–30.
doi: 10.1007/s12282-018-0901-5 pubmed: 30151780
Raja MA, Straker VF, Rainsbury RM. Extending the role of breast-conserving surgery by immediate volume replacement. Br J Surg. 1997;84:101–5.
pubmed: 9043470
Hernanz F, Regano S, Redondo-Figuero C, Orallo V, Erasun F, Gomez-Fleitas M. Oncoplastic breast-conserving surgery: analysis of quadrantectomy and immediate reconstruction with latissimus dorsi flap. World J Surg. 2007;31:1934–40.
doi: 10.1007/s00268-007-9196-y pubmed: 17674094
Khan LR, Raine CR, Dixon JM. Immediate lipofilling in breast conserving surgery. Eur J Surg Oncol. 2017;43:1402–8.
doi: 10.1016/j.ejso.2017.03.014 pubmed: 28390738
Heine N, Eigenberger A, Brebant V, Kempa S, Seitz S, Pranti L, et al. The effect of radiotherapy on fat engraftment for complete breast reconstruction using lipofilling only. Arch Gynec Obstet. 2022. https://doi.org/10.1007/s00404-022-06610-4 .
doi: 10.1007/s00404-022-06610-4
O’Dey D, Prescher A, Pallua N. Vascular reliability of the nipple-areola complex-bearing pedicles: an anatomical microdissection study. Plast Reconstr Surg. 2007;119(4):1167–77.
doi: 10.1097/01.prs.0000254360.98241.dc pubmed: 17496587
Moran MS, Colasanto JM, Haffty BG, Wilspm LD, Lund MW, Higgins SA. Effects of breast-conserving therapy on lactation after pregnancy. Cancer J. 2005;11(5):399–403.
doi: 10.1097/00130404-200509000-00007 pubmed: 16259870
Pusic AL, Klassen AF, Scott AM, Klok JA, Cordeiro PG, Cano SJ. Development of a new patient-reported outcome measure for breast surgery: the BREAST-Q. Plast Recontr Surg. 2009;124:345–53.
doi: 10.1097/PRS.0b013e3181aee807
Stolpner I, Heil J, Riedel F, Wallwiener M, Schafgen B, FeiBt M, et al. Long-term patient satisfaction and quality of life after breast-conserving therapy: a prospective study using the Breast-Q. Ann Surg Oncol. 2021;28:8742–51.
doi: 10.1245/s10434-021-10377-4 pubmed: 34279753 pmcid: 8591011
Behluli I, Le Renard PE, Rozwag K, Oppelt P, Kaufmann A, Schneider A. Oncoplastic breast surgery versus conventional breast-conserving surgery: a comparative retrospective study. ANZ J Surg. 2019;89:1236–41.
doi: 10.1111/ans.15245 pubmed: 30990940 pmcid: 6849881

Auteurs

Masakuni Noguchi (M)

Department of Breast and Endocrine Surgery, Kanazawa Medical University Hospital, Daigaku 1-1, Uchinada-Kahoku, Ishikawa, 920-0293, Japan. nogumasa@kanazawa-med.ac.jp.
Breast Center, Kanazawa Medical University Hospital, Daigaku 1-1, Uchinada-Kahoku, Ishikawa, Japan. nogumasa@kanazawa-med.ac.jp.

Emi Morioka (E)

Department of Breast and Endocrine Surgery, Kanazawa Medical University Hospital, Daigaku 1-1, Uchinada-Kahoku, Ishikawa, 920-0293, Japan.
Breast Center, Kanazawa Medical University Hospital, Daigaku 1-1, Uchinada-Kahoku, Ishikawa, Japan.

Miki Yokoi-Noguchi (M)

Department of Breast and Endocrine Surgery, Kanazawa Medical University Hospital, Daigaku 1-1, Uchinada-Kahoku, Ishikawa, 920-0293, Japan.
Breast Center, Kanazawa Medical University Hospital, Daigaku 1-1, Uchinada-Kahoku, Ishikawa, Japan.

Yusuke Haba (Y)

Department of Breast and Endocrine Surgery, Kanazawa Medical University Hospital, Daigaku 1-1, Uchinada-Kahoku, Ishikawa, 920-0293, Japan.
Breast Center, Kanazawa Medical University Hospital, Daigaku 1-1, Uchinada-Kahoku, Ishikawa, Japan.

Masafumi Inokuchi (M)

Department of Breast and Endocrine Surgery, Kanazawa Medical University Hospital, Daigaku 1-1, Uchinada-Kahoku, Ishikawa, 920-0293, Japan.
Breast Center, Kanazawa Medical University Hospital, Daigaku 1-1, Uchinada-Kahoku, Ishikawa, Japan.

Machiko Hisano (M)

Breast Center, Kanazawa Medical University Hospital, Daigaku 1-1, Uchinada-Kahoku, Ishikawa, Japan.

Classifications MeSH