Factors affecting cosmesis after breast conserving surgery without oncoplastic techniques in an experienced comprehensive breast center.
Identifieur interne : 000500 ( Main/Exploration ); précédent : 000499; suivant : 000501Factors affecting cosmesis after breast conserving surgery without oncoplastic techniques in an experienced comprehensive breast center.
Auteurs : Tolga Ozmen [États-Unis] ; Ahmet Veysel Polat [États-Unis] ; Ayfer Kamali Polat [États-Unis] ; Marguerite Bonaventura [États-Unis] ; Ronald Johnson [États-Unis] ; Atilla Soran [États-Unis]Source :
- The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland [ 1479-666X ] ; 2015.
Descripteurs français
- KwdFr :
- MESH :
English descriptors
- KwdEn :
- MESH :
- methods : Mastectomy, Segmental.
- statistics & numerical data : Mastectomy, Segmental.
- surgery : Breast Neoplasms.
- therapy : Breast Neoplasms.
- Adult, Aged, Aged, 80 and over, Cosmetic Techniques, Female, Hospitals, Special, Humans, Middle Aged, Retrospective Studies.
Abstract
We aimed to study the factors affecting cosmetic outcome (CO) in breast conserving surgery (BCS) without oncoplastic techniques in our center with a BCS rate higher than 60% in more than 1000 breast cancer surgeries a year. In this study 284 patients who underwent BCS without oncoplastic techniques were included. Surgeries were performed by two experienced breast surgeons with more than 25 years of experience. These patients were followed in our established Wellness Clinic postoperatively. The CO is evaluated according to the "Harvard Breast Cosmesis Grading Scale" by a breast surgeon who did not participate in the patient's surgery. The correlation among patient factors (age, breast volume, menopausal status), tumor factors (size, location, distance to areola) and treatment factors (excision volume, breast skin excision, axillary surgery, adjuvant therapy) and CO were evaluated. The mean age was 57.6 [33-98] years in the successful CO group and 58.1 [34-85] years in the unsuccessful CO group (p > 0.05). The mean follow-up time was 37.9 [24-84] months. The CO was successful in 88.7% (n:252) of the patients. Tumor size, retroareolar location of the tumor, adjuvant chemotherapy administration and whole breast radiation therapy (WBRT) were correlated with a poorer CO (p < 0.05). We were able to attain a successful CO in approximately 90% of our patients. Adding oncoplastic techniques to the surgical management of larger tumors and retroareolar tumors, may increase the percentage of good CO. In selected patients choosing balloon brachytherapy instead of WBRT, may also have positive effects on CO.
DOI: 10.1016/j.surge.2013.12.005
PubMed: 24529831
Affiliations:
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Electronic address: drtolgaozmen@yahoo.com.tr.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Polat, Ahmet Veysel" sort="Polat, Ahmet Veysel" uniqKey="Polat A" first="Ahmet Veysel" last="Polat">Ahmet Veysel Polat</name><affiliation wicri:level="2"><nlm:affiliation>Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Polat, Ayfer Kamali" sort="Polat, Ayfer Kamali" uniqKey="Polat A" first="Ayfer Kamali" last="Polat">Ayfer Kamali Polat</name><affiliation wicri:level="2"><nlm:affiliation>Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Bonaventura, Marguerite" sort="Bonaventura, Marguerite" uniqKey="Bonaventura M" first="Marguerite" last="Bonaventura">Marguerite Bonaventura</name><affiliation wicri:level="2"><nlm:affiliation>Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Johnson, Ronald" sort="Johnson, Ronald" uniqKey="Johnson R" first="Ronald" last="Johnson">Ronald Johnson</name><affiliation wicri:level="2"><nlm:affiliation>Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Soran, Atilla" sort="Soran, Atilla" uniqKey="Soran A" first="Atilla" last="Soran">Atilla Soran</name><affiliation wicri:level="2"><nlm:affiliation>Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author></analytic><series><title level="j">The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland</title><idno type="ISSN">1479-666X</idno><imprint><date when="2015" type="published">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Breast Neoplasms (surgery)</term><term>Breast Neoplasms (therapy)</term><term>Cosmetic Techniques</term><term>Female</term><term>Hospitals, Special</term><term>Humans</term><term>Mastectomy, Segmental (methods)</term><term>Mastectomy, Segmental (statistics & numerical data)</term><term>Middle Aged</term><term>Retrospective Studies</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Hôpitaux spécialisés</term><term>Mastectomie partielle ()</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Techniques cosmétiques</term><term>Tumeurs du sein ()</term><term>Études rétrospectives</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Mastectomy, Segmental</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Mastectomy, Segmental</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Cosmetic Techniques</term><term>Female</term><term>Hospitals, Special</term><term>Humans</term><term>Middle Aged</term><term>Retrospective Studies</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Hôpitaux spécialisés</term><term>Mastectomie partielle</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Techniques cosmétiques</term><term>Tumeurs du sein</term><term>Études rétrospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">We aimed to study the factors affecting cosmetic outcome (CO) in breast conserving surgery (BCS) without oncoplastic techniques in our center with a BCS rate higher than 60% in more than 1000 breast cancer surgeries a year. In this study 284 patients who underwent BCS without oncoplastic techniques were included. Surgeries were performed by two experienced breast surgeons with more than 25 years of experience. These patients were followed in our established Wellness Clinic postoperatively. The CO is evaluated according to the "Harvard Breast Cosmesis Grading Scale" by a breast surgeon who did not participate in the patient's surgery. The correlation among patient factors (age, breast volume, menopausal status), tumor factors (size, location, distance to areola) and treatment factors (excision volume, breast skin excision, axillary surgery, adjuvant therapy) and CO were evaluated. The mean age was 57.6 [33-98] years in the successful CO group and 58.1 [34-85] years in the unsuccessful CO group (p > 0.05). The mean follow-up time was 37.9 [24-84] months. The CO was successful in 88.7% (n:252) of the patients. Tumor size, retroareolar location of the tumor, adjuvant chemotherapy administration and whole breast radiation therapy (WBRT) were correlated with a poorer CO (p < 0.05). We were able to attain a successful CO in approximately 90% of our patients. Adding oncoplastic techniques to the surgical management of larger tumors and retroareolar tumors, may increase the percentage of good CO. In selected patients choosing balloon brachytherapy instead of WBRT, may also have positive effects on CO.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Pennsylvanie</li></region></list><tree><country name="États-Unis"><region name="Pennsylvanie"><name sortKey="Ozmen, Tolga" sort="Ozmen, Tolga" uniqKey="Ozmen T" first="Tolga" last="Ozmen">Tolga Ozmen</name></region><name sortKey="Bonaventura, Marguerite" sort="Bonaventura, Marguerite" uniqKey="Bonaventura M" first="Marguerite" last="Bonaventura">Marguerite Bonaventura</name><name sortKey="Johnson, Ronald" sort="Johnson, Ronald" uniqKey="Johnson R" first="Ronald" last="Johnson">Ronald Johnson</name><name sortKey="Polat, Ahmet Veysel" sort="Polat, Ahmet Veysel" uniqKey="Polat A" first="Ahmet Veysel" last="Polat">Ahmet Veysel Polat</name><name sortKey="Polat, Ayfer Kamali" sort="Polat, Ayfer Kamali" uniqKey="Polat A" first="Ayfer Kamali" last="Polat">Ayfer Kamali Polat</name><name sortKey="Soran, Atilla" sort="Soran, Atilla" uniqKey="Soran A" first="Atilla" last="Soran">Atilla Soran</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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