Zhygulin Andrii
LISOD Israeli Cancer Care Hospital, Ukrain
Title: Oncoplastic and reconstructive surgery single institution experience
Biography
Biography: Zhygulin Andrii
Abstract
Introduction: Breast conserving surgery (BCS) followed by radiation therapy and skin-sparing mastectomy with immediate reconstruction (IR) have proven their efficiency and safety. The technical and oncological aspects of breast oncoplastic surgery in our breast unit, organized according EUSOMA criteria are presented.
Materials & Methods: Treatment was carried out on multidisciplinary tumorboard. During BCS we used therapeutic mammoplasties or flaps from the chest, abdominal wall, LICAP-flaps or LD-flaps. In case of mastectomy we offered immediate reconstruction. Type of reconstruction was chosen according clinical situation. Photos of the patients were performed.
Results: From 2007 to 09.2016 1032 surgeries in 715 patients were performed. 400 oncoplastic BCS were performed in 392 patients. Average age was 53.2(22-88), tumor size – 2,15cm (0, 8-15), weight of specimen - 109g (6-1034). We used therapeutic mammaplasties in 140 (35.0%) cases, local chest wall flaps - in 93 (23.3%). Complications had 102(25.5%) patients. We followed up 342 (87.2%) patients during 35.5 (6-108) months. Local recurrence occurred in 8(2.3%) patients. 35(10.2%) patients had metastasis, 18(5.3%) of them died. In IR group 148 immediate reconstructions were performed in 123 patients. The average age was 45 (29-71).We did 68 (45.9%) one-stage reconstructions, 26(17.5%) - with ADM, 17(11.5%) - with synthetic mesh. Two-stage surgeries were done in 56(37.8%) cases. LD-flap was done in 9(6.8%) patients, LD-flap + implant - in 11(7.4%), pedicled TRAM-flap - in 4(2.7%). Skin-sparing mastectomy was performed in 30(20.3%) patients, skin-reducing - in 38(25, 7%), nipple-sparing in 55(37,2%). We followed up 103(83.7%) patients during 32 months (6-84). Local recurrence was found in 1(0.9%) patient, distant metastases - in 17(16.5%) and 6(5.8%) of them died. Early complications were found in 51(34.4%) cases.
Conclusions: We evaluated our experience in oncoplastic BCS and reconstructive surgery in a dedicated BU that would allow for radical treatment with excellent aesthetical outcomes.