Breast Conserving surgery is a suitable option for early breast carcinoma in a conservative society of middle income country - early experiences
Research Article


DOI:
https://doi.org/10.58372/2835-6276.1317Abstract
Introduction: Breast conserving surgery now a days are most common preferred surgery for breast cancer patients other then mastectomy . Oncoplastic Surgery can be a safer, more cost effective alternate to conventional BCS owing to its higher rate of negative surgical margins and better cosmetic results. In Asian countries, the rate of Breast conservation surgery is low and the cause are multifactorial such as availability and accessibility of investigation, infrastructure ,oncology and pathological support and surgeon’s choice. Aim is to elucidate the surgeons’ perspective while choosing between BCS and mastectomy, in women oncologicaly eligible for BCS.
Methods: A retrospective study in Z.H.Sikder Women’s Medical College Hospital,a single Centre based study by reviewing patient’s medical records from August 2021 to July 2023 was conducted. Percentage of patient agreed for breast conservation surgery along with mean tumor size, type of cancer and different surgical procedures with postoperative complication was assessed.
Results: A total of 199 patients were eligible for BCS but 75.87% patients showed unwillingness to go for BCS. 48 patients responses were included who underwent for BCS. The mean age of the participants was 43 years and of the 48 patients in the study, 46 had unilateral and 2 had bilateral BC. 74.37 % of patients tumor size was 1-2 cm . 5 patients received NACT; none achieved a complete clinical response. Majority of (73.9%) of tumor biology shows ER, PR positive and HER 2 negative. 36 patients diagnosed with IDC and second common cancer id ILC . Breast conservation surgery was the commonest surgery to remove the cancer and 27 patients had WLE and glandular repair. 21 patients required level II oncoplastic techniques. No major complications or local recurrences were observed.
Conclusions: Implementing breast-conserving surgery as the standard of care breast cancer patients where appropriate. Breast-conserving surgery is not only safe, but also highly beneficial in terms of aesthetics, body image, and quality of life. Adoption of these techniques into practice can increase indications of BCT and requires a team approach for best success.
References
Baildam A.D. Oncoplastic surgery of the breast. Br. J. Surg. 2002;89:532–533. doi: 10.1046/j.1365-2168.2002.02077.x. [DOI] [PubMed] [Google Scholar]
Anderson B.O., Yip C.H., Smith R.A., Shyyan R., Sener S.F., Eniu A., et al. John Wiley and Sons Inc.; 2008. Guideline Implementation for Breast Healthcare in Low-Income and Middle-Income Countries: Overview of the Breast Health Global Initiative Global Summit 2007. Cancer; pp. 2221–2243. [DOI] [PubMed] [Google Scholar]
Silverstein M.J., Savalia N., Khan S., Ryan J. Extreme oncoplasty: breast conservation for patients who need mastectomy. Breast J. 2015;21(1):52–59. doi: 10.1111/tbj.12356. [DOI] [PMC free article] [PubMed] [Google Scholar]
Freitas-Junior R, Ferreira-Filho DL, Soares LR, Paulinelli RR. Oncoplastic Breast-Conserving Surgery in Low- and Middle Income Countries: Training Surgeons and Bridging the Gap. Curr Breast Cancer Rep 2019;11:136-42. Doi: 10.1007/s12609-019-00317-3.
Sakina Abidi S, Mushtaque Vohra L, Rizwan Javed M, Khan N. Oncoplastic surgery: A suitable alternative to conventional breast conserving surgery in low - Middle income countries; a retrospective cohort study. Ann Med Surg (Lond) 2021;68:e102618. doi: 10.1016/j.amsu.2021.102618.
Youssef MM, Namour A, Youssef OZ, Morsi A. Oncologic and cosmetic outcomes of oncoplastic breast surgery in locally advanced breast cancer after neoadjuvant chemotherapy, experience from a developing country. Indian J Surg Oncol 2018;9:300-6. doi: 10.1007/s13193-017-0689-3.
Malycha PL, Gough IR, Margaritoni M, Deo SV, Sandelin K, Buccimazza I, et al. Oncoplastic breast surgery: a global perspective on practice, availability, and training. World J Surg 2008;32:2570-7. doi: 10.1007/s00268-008-9635-4.
Vohra L, Siddiqui T, Farooqi N. Oncoplastic breast conserving surgery in developing country: Challenges, promises and outcome. Eur J Surg Oncol 2019;45:e93. doi:10.1016/j.ejso.2018.10.328.
Soomro R. Breast Surgery Fellowship: Need of Contemporary Times. J Coll Physicians Surg Pak 2019;29:1023-4. doi: 10.29271/jcpsp.2019.11.1023.
Veronesi U., Cascinelli N., Mariani L., Greco M., Saccozzi R., Luini A., Aguilar M., Marubini E. Twenty-year follow-up of a randomized study comparing breastconserving surgery with radical mastectomy for early breast cancer. N. Engl. J. Med. 2002;347:1227–1232. doi: 10.1056/NEJMoa020989. [DOI] [PubMed] [Google Scholar]
Anderson B., Masetti R., Silverstein M. Oncoplastic approaches to partial mastectomy: an overview of volume displacement techniques. Lancet Oncol. 2005;6:145–157. doi: 10.1016/S1470-2045(05)01765-1. [DOI] [PubMed] [Google Scholar]
Clough K., Lewis J.S., Couturald B., Fitoussi A., Nos C., Falcou M.C. Oncoplastic techniques allow extensive resections for breast conserving therapy of breast carcinomas. Ann. Surg. 2003;237:26–34. doi: 10.1097/00000658-200301000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
Clough K., Kaufman G., Nos C., Buccimazza I., Sarfati I. Improving breast cancer surgery: a classification and quadrant per quadrant atlas for oncoplastic surgery. Ann. Surg Oncol. 2010;17:1375–1391. doi: 10.1245/s10434-009-0792-y. [DOI] [PubMed] [Google Scholar]
Silverstein M.J. The van nuys Breast Center-The first freestanding multidisciplinary breast center. Surg. Oncol. Clin. 2000;9:159–175. [PubMed] [Google Scholar]
Silverstein M.J., Handel N., Hoffman R., Gamagami P., Gierson E. In: Fundamental Problems in Breast Cancer. Paterson L.A., AHG, editors. Martinus Nijhoff; Boston, MA: 1987. The Breast Center-A multidisciplinary model; pp. 47–58. [Google Scholar]
Rew D.A. Towards a scientific basis for oncoplastic breast surgery. Eur. J. Surg. Oncol. 2003;29:105–106. doi: 10.1053/ejso.2002.1410. [DOI] [PubMed] [Google Scholar]
Bordoni Daniele. Extreme oncoplastic breast surgery: a case report. Int. J. Surg. Case Rep. 2016;28:182–187. doi: 10.1016/j.ijscr.2016.09.037. [DOI] [PMC free article] [PubMed] [Google Scholar]
Agha R.A., Sohrabi C., Mathew G., et al. The PROCESS 2020 guideline: updating consensus preferred reporting of CasESeries in surgery (PROCESS) guidelines. Int. J. Surg. 2020 doi: 10.1016/j.ijsu.2020.11.005. [DOI] [PubMed] [Google Scholar]
Martei Y.M., Pace L.E., Brock J.E., Shulman L.N. Breast cancer in low- and middle-income countries: why we need pathology capability to solve this challenge. Clin. Lab. Med. W.B. Saunders. 2018:161–173. doi: 10.1016/j.cll.2017.10.013. [DOI] [PMC free article] [PubMed] [Google Scholar]
Lynch S.P., Lei X., Hsu L., Meric-Bernstam F., Buchholz T.A., Zhang H., et al. Breast cancer multifocality and multicentricity and locoregional recurrence. Oncol. 2013;18:1167–1173. doi: 10.1634/theoncologist.2013-0167. [DOI] [PMC free article] [PubMed] [Google Scholar]
Christiansen P., Carstensen S.L., Ejlertsen B., Kroman N., Offersen B., Bodilsen A., et al. Breast conserving surgery versus mastectomy: overall and relative survival—a population based study by the Danish Breast Cancer Cooperative Group (DBCG) Acta Oncol. 2018;57:19–25. doi: 10.1080/0284186X.2017.1403042. [DOI] [PubMed] [Google Scholar]
Kaufman C.S. Increasing role of oncoplastic surgery for breast cancer. Curr. Oncol. Rep. 2019 doi: 10.1007/s11912-019-0860-9. Springer. [DOI] [PMC free article] [PubMed] [Google Scholar]
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