Modern trends in the breast cancer conserving surgery and oncoplastic breast surgery

Introduction: The highest priority for modern clinical oncology is functionally-sparing and organ-conserving treatment. In Russia, breast cancer (BC), among all malignant tumors, accounted for 21.1 % of women in 2017. Oncoplastic radical resections (OPS-BCS = oncoplastic surgery – breast conserving surgery) have been widely used. This term means resection of the breast for cancer using plastic surgery to restore the shape of the breast, in most cases with one-stage correction of the contralateral breast. Purpose: It was the creation of various techniques of oncoplastic breast surgery, applicable for the appropriate localization of breast cancer and the evaluation of surgical, oncological and aesthetic results. Methods: From 2013 to 2017, in the P.A. Hertsen Moscow Oncology Research Center, organ-conserving surgery were performed in 570 patients with BC with an average age of 54.2. Stage 0 was diagnosed in 4.6 %, I – 5.9 %, IIA – 28.7 %, IIB – 6 %, IIIA – 5.1 %, IIIC – 3.3 %, IIIB – 0.2 %, IV – 0.2 %. Radical resection in the standard version was performed in 290 patients with breast cancer, oncoplastic breast surgery in various modifications – in 280. All patients after the organ-conserving surgical treatment received radiation therapy. Patients received chemotherapy, targeted therapy and hormone therapy according to the indications in depending the disease stage and the immunohistochemical type of the tumor. Results: After an urgent and planned morphological study positive margins of resection were revealed in 10 patients, which required reresection of the edges to a negative state of them in case of an urgent intraoperative response and mastectomy – in case of a planned response. Within 4 years, local recurrences were detected in 4 patients (0.7 %), which required a mastectomy with a one-stage reconstruction. In 1 patient (0.2 %), the disease progressed as metastases to the lung – in this case lobectomy and a necessary chemotherapy were conducted. Cosmetic results were defined as excellent in 70 % cases, good – 25 %, satisfactory – 5 %. Conclusion: If there are indications for organ-conserving treatment of breast cancer and the patient’s decision concerning this surgery, the patient should be offered methods of oncoplastic surgery for the prevention of psychological and emotional stress, effective rehabilitation, and a quick return to active social life. © 2018 Medical Radiology and Radiation Safety. All rights reserved