Subaxillary Replacement Flap Compared with the Round Block Displacement Technique in Oncoplastic Breast Conserving Surgery: Functional Outcomes of a Feasible One Stage Reconstruction
Background: For selected women diagnosed with breast cancer (BC), partial reconstructive techniques involve displacement or replacement procedures to improve cosmesis without compromising oncological safety. This study aims to evaluate the surgical outcomes of the round block (RB) compared with the...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-11-01
|
| Series: | Current Oncology |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1718-7729/29/12/736 |
| _version_ | 1797460727856889856 |
|---|---|
| author | Paolo Orsaria Antonella Grasso Georgeta Soponaru Francesca Carnevale Virginia Scorsone Edy Ippolito Francesco Pantano Matteo Sammarra Claudia Piccolo Michele Altomare Giuseppe Perrone Vittorio Altomare |
| author_facet | Paolo Orsaria Antonella Grasso Georgeta Soponaru Francesca Carnevale Virginia Scorsone Edy Ippolito Francesco Pantano Matteo Sammarra Claudia Piccolo Michele Altomare Giuseppe Perrone Vittorio Altomare |
| author_sort | Paolo Orsaria |
| collection | DOAJ |
| description | Background: For selected women diagnosed with breast cancer (BC), partial reconstructive techniques involve displacement or replacement procedures to improve cosmesis without compromising oncological safety. This study aims to evaluate the surgical outcomes of the round block (RB) compared with the subaxillary flap (SF) technique for patients with upper outer tumor. Patients and Methods: Thirty-three patients treated with oncoplastic conserving surgery (15 RB and 18 SF) were enrolled in this retrospective study. After carrying out a comparison of baseline characteristics, all cases were recruited for postoperative evaluation of oncological and cosmetic parameters. Moreover, we investigated several scoring combinations to check whether they could discriminate surgeon and patient satisfaction according to different functional results. Results: Median age (<i>p</i> < 0.05), average tumor size (<i>p</i> > 0.05), estimated resection volume (<i>p</i> > 0.05), and nodal involvement (<i>p</i> > 0.05) were slightly higher in the SF group. A greater frequency of DCIS (<i>p</i> < 0.05) in the RB series correlated with reintervention for positive margins (<i>p</i> > 0.001). At a mean follow-up of 19 months, no locoregional recurrences were recorded and early and late complications were comparable (<i>p</i> > 0.05). The overall satisfaction with cosmesis was characterized by similar proportions of good results (<i>p</i> > 0.05), with some details more related to each procedure. Conclusion: The proposed techniques represent effective solutions for reshaping that follows upper outer wide excision, achieving comparable complication rates, low reinterventions, and good aesthetic results in relation to technical and social functioning evaluations. However, it is crucial to establish a careful patient selection in order to manage correct surgical planning while predicting any potential sequelae or complication. |
| first_indexed | 2024-03-09T17:09:11Z |
| format | Article |
| id | doaj.art-470bddd13d3f4cb2adfac7a81a25b04a |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-09T17:09:11Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-470bddd13d3f4cb2adfac7a81a25b04a2023-11-24T14:12:39ZengMDPI AGCurrent Oncology1198-00521718-77292022-11-0129129377939010.3390/curroncol29120736Subaxillary Replacement Flap Compared with the Round Block Displacement Technique in Oncoplastic Breast Conserving Surgery: Functional Outcomes of a Feasible One Stage ReconstructionPaolo Orsaria0Antonella Grasso1Georgeta Soponaru2Francesca Carnevale3Virginia Scorsone4Edy Ippolito5Francesco Pantano6Matteo Sammarra7Claudia Piccolo8Michele Altomare9Giuseppe Perrone10Vittorio Altomare11Department of Breast Surgery, Campus Bio-Medico University, 00159 Rome, ItalyDepartment of Breast Surgery, Campus Bio-Medico University, 00159 Rome, ItalyDepartment of Breast Surgery, Campus Bio-Medico University, 00159 Rome, ItalyDepartment of Breast Surgery, Campus Bio-Medico University, 00159 Rome, ItalyDepartment of Breast Surgery, Campus Bio-Medico University, 00159 Rome, ItalyDepartment of Radiation Oncology, Campus Bio-Medico University, 00159 Rome, ItalyDepartment of Medical Oncology, Campus Bio-Medico University, 00159 Rome, ItalyDepartment of Radiology, Campus Bio-Medico University, 00159 Rome, ItalyDepartment of Radiology, Campus Bio-Medico University, 00159 Rome, ItalyDepartment of Trauma and Acute Care, Metropolitano Niguarda Hospital, 20162 Milan, ItalyDepartment of Anatomical Pathology, Campus Bio-Medico University, 00139 Rome, ItalyDepartment of Breast Surgery, Campus Bio-Medico University, 00159 Rome, ItalyBackground: For selected women diagnosed with breast cancer (BC), partial reconstructive techniques involve displacement or replacement procedures to improve cosmesis without compromising oncological safety. This study aims to evaluate the surgical outcomes of the round block (RB) compared with the subaxillary flap (SF) technique for patients with upper outer tumor. Patients and Methods: Thirty-three patients treated with oncoplastic conserving surgery (15 RB and 18 SF) were enrolled in this retrospective study. After carrying out a comparison of baseline characteristics, all cases were recruited for postoperative evaluation of oncological and cosmetic parameters. Moreover, we investigated several scoring combinations to check whether they could discriminate surgeon and patient satisfaction according to different functional results. Results: Median age (<i>p</i> < 0.05), average tumor size (<i>p</i> > 0.05), estimated resection volume (<i>p</i> > 0.05), and nodal involvement (<i>p</i> > 0.05) were slightly higher in the SF group. A greater frequency of DCIS (<i>p</i> < 0.05) in the RB series correlated with reintervention for positive margins (<i>p</i> > 0.001). At a mean follow-up of 19 months, no locoregional recurrences were recorded and early and late complications were comparable (<i>p</i> > 0.05). The overall satisfaction with cosmesis was characterized by similar proportions of good results (<i>p</i> > 0.05), with some details more related to each procedure. Conclusion: The proposed techniques represent effective solutions for reshaping that follows upper outer wide excision, achieving comparable complication rates, low reinterventions, and good aesthetic results in relation to technical and social functioning evaluations. However, it is crucial to establish a careful patient selection in order to manage correct surgical planning while predicting any potential sequelae or complication.https://www.mdpi.com/1718-7729/29/12/736breast canceroncoplastic surgerydisplacementreplacementcosmetic outcomes |
| spellingShingle | Paolo Orsaria Antonella Grasso Georgeta Soponaru Francesca Carnevale Virginia Scorsone Edy Ippolito Francesco Pantano Matteo Sammarra Claudia Piccolo Michele Altomare Giuseppe Perrone Vittorio Altomare Subaxillary Replacement Flap Compared with the Round Block Displacement Technique in Oncoplastic Breast Conserving Surgery: Functional Outcomes of a Feasible One Stage Reconstruction Current Oncology breast cancer oncoplastic surgery displacement replacement cosmetic outcomes |
| title | Subaxillary Replacement Flap Compared with the Round Block Displacement Technique in Oncoplastic Breast Conserving Surgery: Functional Outcomes of a Feasible One Stage Reconstruction |
| title_full | Subaxillary Replacement Flap Compared with the Round Block Displacement Technique in Oncoplastic Breast Conserving Surgery: Functional Outcomes of a Feasible One Stage Reconstruction |
| title_fullStr | Subaxillary Replacement Flap Compared with the Round Block Displacement Technique in Oncoplastic Breast Conserving Surgery: Functional Outcomes of a Feasible One Stage Reconstruction |
| title_full_unstemmed | Subaxillary Replacement Flap Compared with the Round Block Displacement Technique in Oncoplastic Breast Conserving Surgery: Functional Outcomes of a Feasible One Stage Reconstruction |
| title_short | Subaxillary Replacement Flap Compared with the Round Block Displacement Technique in Oncoplastic Breast Conserving Surgery: Functional Outcomes of a Feasible One Stage Reconstruction |
| title_sort | subaxillary replacement flap compared with the round block displacement technique in oncoplastic breast conserving surgery functional outcomes of a feasible one stage reconstruction |
| topic | breast cancer oncoplastic surgery displacement replacement cosmetic outcomes |
| url | https://www.mdpi.com/1718-7729/29/12/736 |
| work_keys_str_mv | AT paoloorsaria subaxillaryreplacementflapcomparedwiththeroundblockdisplacementtechniqueinoncoplasticbreastconservingsurgeryfunctionaloutcomesofafeasibleonestagereconstruction AT antonellagrasso subaxillaryreplacementflapcomparedwiththeroundblockdisplacementtechniqueinoncoplasticbreastconservingsurgeryfunctionaloutcomesofafeasibleonestagereconstruction AT georgetasoponaru subaxillaryreplacementflapcomparedwiththeroundblockdisplacementtechniqueinoncoplasticbreastconservingsurgeryfunctionaloutcomesofafeasibleonestagereconstruction AT francescacarnevale subaxillaryreplacementflapcomparedwiththeroundblockdisplacementtechniqueinoncoplasticbreastconservingsurgeryfunctionaloutcomesofafeasibleonestagereconstruction AT virginiascorsone subaxillaryreplacementflapcomparedwiththeroundblockdisplacementtechniqueinoncoplasticbreastconservingsurgeryfunctionaloutcomesofafeasibleonestagereconstruction AT edyippolito subaxillaryreplacementflapcomparedwiththeroundblockdisplacementtechniqueinoncoplasticbreastconservingsurgeryfunctionaloutcomesofafeasibleonestagereconstruction AT francescopantano subaxillaryreplacementflapcomparedwiththeroundblockdisplacementtechniqueinoncoplasticbreastconservingsurgeryfunctionaloutcomesofafeasibleonestagereconstruction AT matteosammarra subaxillaryreplacementflapcomparedwiththeroundblockdisplacementtechniqueinoncoplasticbreastconservingsurgeryfunctionaloutcomesofafeasibleonestagereconstruction AT claudiapiccolo subaxillaryreplacementflapcomparedwiththeroundblockdisplacementtechniqueinoncoplasticbreastconservingsurgeryfunctionaloutcomesofafeasibleonestagereconstruction AT michelealtomare subaxillaryreplacementflapcomparedwiththeroundblockdisplacementtechniqueinoncoplasticbreastconservingsurgeryfunctionaloutcomesofafeasibleonestagereconstruction AT giuseppeperrone subaxillaryreplacementflapcomparedwiththeroundblockdisplacementtechniqueinoncoplasticbreastconservingsurgeryfunctionaloutcomesofafeasibleonestagereconstruction AT vittorioaltomare subaxillaryreplacementflapcomparedwiththeroundblockdisplacementtechniqueinoncoplasticbreastconservingsurgeryfunctionaloutcomesofafeasibleonestagereconstruction |