MANAGEMENT OF LARGE SIZE AND MULTIPLE BENIGN BREAST LESIONS USING ONCOPLASTIC SURGICAL SKILLS
Objective: Management of multiple and large size benign breast lesions is challenging. Usual excision techniques are associated with unacceptable breast deformity in such cases. However, these can effectively be managed with minimum breast deformity using oncoplastic skills used for breast cancer. Our objective was to evaluate the oncological outcome and patient satisfaction of managing large and multiple benign breast lesions using oncoplastic surgical skills.
Methods: This was a descriptive, prospective study conducted in department of Surgery, Madina Teaching Hospital, Faisalabad, Pakistan from January 2018 to December 2019. Females with age range of 12 to 60 years were included in the study. Different oncoplastic techniques were used depending on location and size of tumour as well as size and degree of breast ptosis.Main outcome measures were tumour recurrence and patient satisfaction with the cosmetic outcome.
Results: Twenty-eight female patients with large size (>5cm) or multiple benign breast tumors were managed.Most common techniques used were round block mammoplasty and wise pattern reduction mammoplasty. Giant fibroadenoma (35.7%), benign phyllodestumour (14%) and ductal hyperplasia (usual 10.7% & atypical 7%) were the most common histological findings. No tumour recurrence was seen during our study period and minimum scarring and no breast deformity in these cases, gained high patient satisfaction.
Conclusion: Oncoplastic skills achievefavourable aesthetic and oncological results for large and multiple benign breast tumours.
Bertozzi, N., Pesce, I.M., Santip, L., Raposio, E.(2017)‘Oncoplastic breast surgery: comprehensive review’,European Review for Medical and Pharmacological Sciences21(11), pp: 2572-2585
Chirappapha,P., Lertsithichai, P., Sukarayothin, T., Leesombatpaiboon, M., Supsamutchai, C., KongdonY. (2016) ‘Special Therapeutic problems in benign breast conditions’, Gland Surg; 5(1), pp: 75-82.
de Roos, W.K., Kaye, P& Dent DM. (1999)‘Factors leading to local recurrence or death after surgical resection of phyllodes tumours of the breast’,British Journal of Surgery; 86(3), pp:396-399.
Dolmans, H.C.G. Guido., Hoogbergen, M.H & van Rappard,J.H.A. (2007)‘Giant fibroadenoma of one breast: Immediate bilateral reconstruction’, Journal of Plastic, Reconstructive & Aesthetic Surgery; 60 (10), pp. 1156 – 1157.
Guray, M and Sahin, A.A. (2006) ‘Benign breast diseses : Classification, Diagnosis and management’, The Oncologist; 11(5), pp: 435-449
Hiller, A., Lee, T.J., Henderson, J., Ajkay, N., Wilhelmi, B.J. (2018)‘Oncoplasticreduction pattern technique following removal of giant fibroadenoma’, Eplasty; 18(4), pp: 28-34
Kaviani, A., Najafi, M & Salmon, J. (2015) ‘Oncological Outcome of Oncoplastic Breast Surgery: A Review of the Literature’, Archives of Breast Cancer; 2(1), pp: 5-14.
King, K.S., Harrington, M.A., Kassira N. (2017) ‘Recurrent giant juvenile fibroadenoma’, Journal of Pediatric Surgery Case Reports; 26, pp:42-45
Neal,L., Sandhu, N.P., Hieken, T.J., Glazebrook, K.N., Mac Bride, M.B., Dilaveri,C.A, Wahner-Roedler, D.L., Ghosh, K., Visscher, D.W. (2014) ‘Diagnosis and management of benign, atypical and indeterminate breast lesions detected on core needle biopsy’,Mayo Clinic Proceedings; 89(4), pp:536-547
Okoth, C., Moses,Galukande, M., Jombwe, J &Wamala, D.(2013) ’Benign proliferative breast diseases among female patients at a sub Saharan Africa tertiary hospital: a cross sectional study’, Biomed central Surgery; 13(1), pp: 9.
Pukancsik, D., Kelemen, P., Ujhelyi,M., Kovacs,T., Kasler, M., Matrai,Z. (2017) ‘Objective decision making between conventional and oncoplastic breast conserving surgery or mastectomy: An aesthetic and functional prospective cohort study’,European Journal of Surgical Oncology; 43(2), pp: 303-310.
Reinfuss, M.,Mituś, J., Duda, K., Stelmach, A., Ryś, J., Smolak, K. (1996) ‘The treatment and prognosis of patients with phyllodestumor of the breast: an analysis of 170 cases’, Cancer;77(5), pp: 910-916.
Saleem, S., Javed, F., Rehman, A., Hayat, N., Bano, N., Ahmad, I&Ahmad T. (2019) ‘Oncological and Cosmetic outcome of Oncoplastic breast surgery’,The Professional Medical Journal; 26(12), pp: 2222-2230.
Simmons, R.M., Cance, W.G., Lacicca, M.V. (2000) A giant juvenile fibroadenoma in a 12-year-old girl: a case for breast conservation. The Breast Journal;6(6), pp:418-420.
Wendy, K. Ng., Mrad, M.A& Brown, M.H. (2011) ‘Juvenile fibroadenoma of the breast: Treatment and literature review’, Canadian Journal of Plastic Surgery; 19 (3), pp:105-107
Yazar, S.K., Altinel, D., Serin,M., Aksoy, S and Yazar, M.(2018) ‘Oncoplastic breast conserving surgery: Aesthetic satisfaction and oncologicl outcomes’, European Journal of Breast Health; 14 (1), pp: 35-38.
Zhang, W., Jin, Z &Baikpour, M. (2019) ‘Clinical application of ultrasound-guided percutaneous microwave ablation for benign breast lesions: a prospective study’, BMC Cancer; 19(1) pp:345