#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#
preLekára.sk / Journals / Perspectives in Surgery / 2024 - 7

Current trends in breast cancer surgery

Česká verzia

Authors: Z. Chaloupková 1 ;  O. Coufal 1,2 ;  L. Gabrielová 1,2
Authors place of work: Oddělení mamokutánní, a onkoplastické chirurgie, Klinika operační, onkologie, MOÚ, Brno 1;  Lékařská fakulta MU, Brno 2
Published in the journal: Rozhl. Chir., 2024, roč. 103, č. 7, s. 247-254.
Category: Review
doi: https://doi.org/10.48095/ccrvch2024247

Summary

The incidence of breast cancer has been increasing significantly over the past decades, while the mortality rate has, actually, been decreasing. Behind this favorable trend in the decrease in mortality are not only high-quality screening programs, but also undoubtedly advances in therapy, especially new methods in surgical treatment. The importance of oncoplastic approach integrating resection and reconstruction procedures is obvious. Our efforts continue to maximize breast-conserving therapy, which is being improved in parallel with the development of new localization methods of non-palpable lesions. Breast-conserving therapy indication spectrum is also increasing with the use of oncoplastic approach allowing the resection of a significant part of the mammary gland while achieving an acceptable cosmetic result. We improve guidelines for skin-sparing procedures and also possibilities and availability of breast reconstruction. Most popular is breast reconstruction with free abdominal flap transfer. However, due to such demanding complex procedure with limited availability, there is also a significant development of silicone-implant-based reconstruction or methods of fat transfer. Constant attention is focused on axillary surgery, now especially in cases of initial nodal involvement that responds favorably to neoadjuvant systemic treatment. Current findings indicate tendency to modify and differentiate surgical indications according to the tumor phenotype. Complex lymphedema prevention surgery, such as lymphatic mapping or restoring lymphatic flow via microsurgical lymphaticovenous anastomosis, can provide effective and long-term improvement and is challenging. Recently in the Czech Republic, we reopened the discussion about the optimal concentration of medical care in a smaller number of specialized breast centers, which we think is one of a number of steps on the constant path to improve medical results.

Keywords:

breast cancer – lymphedema – breast reconstruction – oncoplastic approach – targeted axillary dissection

Zdroje
  1. Biganzoli L, Cardoso F, Beishon M et al. The requirements of a specialist breast centre. Breast 2020; 51: 65–84. doi: 10.1016/j.breast.2020.02.003.
  2. Kesson E, Allardice G, George D et al. Effects of multidisciplinary team working on breast cancer survival: retrospective, comparative, interventional cohort study of 13 722 women. BMJ 2012; 344: e2718. doi: 10.1136/bmj.e2718.
  3. Deutschmann CH, Singer CH, Gschwantler-Kaulich D et al. Residual fibroglandular breast tissue after mastectomy is associated with an increased risk of a local recurrence or a new primary breast cancer. BMC Cancer 2023; 23(1): 281. doi: 10.1186/ s12885-023-10764-y.
  4. Banys-Paluchowski M, Rubio IT, Ditsch N et al. Real de-escalation or escalation in disguise? Breast 2023; 69: 249–257. doi: 10.1016/j.breast.2023.03.001.
  5. Banys-Paluchowski M, Hartmann S, Ditsch N et al. Locoregional therapy: from mastectomy to reconstruction, targeted surgery, and ultra-hypofractionated radiotherapy. Breast Care (Basel) 2023; 18(6): 428–439. doi: 10.1159/000533748.
  6. Hamdi M. Oncoplastic and reconstructive surgery of the breast. Breast 2013; 22(Suppl 2): S100–S105. doi: 10.1016/j.breast.2013. 07. 019.
  7. Mohamedahmed AY, Zaman S, Zafar S et al. Comparison of surgical and oncological outcomes between oncoplastic breast-conserving surgery versus conventional breastconserving surgery for treatment of breast cancer: a systematic review and meta-analysis of 31 studies. Surg Oncol 2022; 42: 101779. doi: 10.1016/j.suronc.2022.101779.
  8. Ditsch N, Rubio IT, Gasparri ML et al. Breast and axillary surgery in malignant breast disease: a review focused on literature of 2018 and 2019. Curr Opin Obstet Gynecol 2020; 32(1): 91–99. doi: 10.1097/GCO.0000000000000593.
  9. Kelsall J, McCulley S, Brock L et al. Comparing oncoplastic breast conserving surgery with mastectomy and immediate breast reconstruction: case-matched patient reported outcomes. J Plast Reconstr Aesthet Surg 2017; 70(10): 1377–1385. doi: 10.1016/j.bjps.2017.05.009.
  10. Banys-Paluchowski M, Kühn T, Masannat Y et al. Localization techniques for nonpalpable breast lesions: current status, knowledge gaps, and rationale for the MELODY study (EUBREAST-4/iBRA-NET,NCT 05559411). Cancers (Basel) 2023;15(4): 1173. doi: 10.3390/cancers15041173.
  11. Jeffries DO, Dossett LA, Jorns JM. Localization for breast surgery: the next generation. Arch Pathol Lab Med 2017; 141(10): 1324–1329. doi: 10.5858/ arpa.2017-0214-RA.
  12. Gabrielova L, Selingerova I, Zatecky J et al. Comparison of 3 different systems for non-wire localization of lesions in breast cancer surgery. Clin Breast Cancer 2023; 23(6): e323–e330. doi: 10.1016/j. clbc.2023.05.006.
  13. Elzohery YH, Gomaa MM, Mohamed G et al. Comparison of wire-guided localization (WGL) and radio-guided occult lesion localization (ROLL) in localization of non-palpable breast lesions. World J Surg Oncol 2023; 21(1): 266.doi:10.1186/ s12957-023-03152-0.
  14. Ivanov V, Dimov R, Marinov B et al. Intraoperative ultrasound for nonpalpable breast lesions – experience and operative time. Folia Med (Plovdiv) 2023; 65(1): 16–19. doi: 10.3897/folmed.65.e76193.
  15. Boughey JC, Rosenkranz KM, Ballman KV et al. Local recurrence after breastconserving therapy in patients with multiple ipsilateral breast cancer: results from ACOSOG Z11102 (alliance). J Clin Oncol 2023; 41(17): 3184–3193. doi: 10.1200/JCO.22.02553.
  16. Masannat YA, Agrawal A, Maraqa L et al. Multifocal and multicentric breast cancer, is it time to think again? Ann R Coll Surg Engl 2020; 102(1): 62–66. doi: 10.1308/rcsann.2019.0109.
  17. De Lorenzi F, Borelli F, Pagan E et al. Oncoplastic breast-conserving surgery for synchronous multicentric and multifocal tumors: is it oncologically safe? A retrospective matched-cohort analysis. Ann Surg Oncol 2022; 29(1): 427–436. doi: 10.1245/s10434-021-10800-w.
  18. Galimberti V, Vicini E, Corso G et al. Nipple-sparing and skin-sparing mastectomy: review of aims, oncological safety and contraindications. Breast 2017; 34 (Suppl 1): S82–S84. doi: 10.1016/j.breast.2017.06.034.
  19. Zaborowski AM, Roe S, Rothwell J et al. A systematic review of oncological outcomes after nipple-sparing mastectomy for breast cancer. J Surg Oncol 2023; 127(3): 361–368. doi: 10.1002/ jso.27115.
  20. Morrow M. Robotic mastectomy: the next major advance in breast cancer surgery? Br J Surg 2021; 108(3): 233–234. doi: 10.1093/bjs/znab010.
  21. Sarfati B, Struk S, Leymarie N et al. Robotic nipple-sparing mastectomy with immediate prosthetic breast reconstruction: surgical technique. Plast Reconstr Surg 2018; 142(3): 624–627. doi: 10.1097/PRS.0000000000004703.
  22. H-W Lai, Toesca A, Sarfati B et al. Consensus statement on robotic mastectomy-expert panel from international endoscopic and robotic breast surgery symposium (IERBS) 2019. Ann Surg 2020; 271(6): 1005–1012. doi: 10.1097/SLA.0000000000003789.
  23. Salgarello M, Visconti G. Designing lateral thoracic wall perforator flaps for breast reconstruction using ultrasound. J Reconstr Microsurg 2022; 38(3): 228–232. doi: 10.1055/s-0041-1740127.
  24. Karakatsanis A, Sund M, Rocco N et al. Chest wall perforator flaps for breast reconstruction: international survey on attitudes and training needs. Br J Surg 2023; 110(8): 966–972. doi: 10.1093/bjs/znad145.
  25. Aziz MB, Rose J. Breast reconstruction perforator Flaps. [online]. Dostupné z: https://www.ncbi.nlm.nih.gov/books/ NBK565866/.
  26. Salgarello M, Fabbri M, Visconti G et al. Implant-based breast reconstruction after nipple-sparing and skin-sparing mastectomy in breast-augmented patients: prepectoral or submuscular direct-to-implant reconstruction. Aesthet Surg J 2023; 44(5): 503–515. doi: 10.1093/asj/sjad383.
  27. De Vita R, Villanucci A, Buccheri EM et al. Extended clinical experience with nipplesparing mastectomy and prepectoral polyurethane implant positioning (BRAND4P method). Clin Breast Cancer 2022; 22(5): e623–e628. doi: 10.1016/j.clbc.2022. 03. 005.
  1. Vidya R, Berna G, Sbitany H et al. Prepectoral implant-based breast reconstruction: a joint consensus guide from UK, European and USA breast and plastic reconstructive surgeons. Ecancermedicalscience 2019; 13: 927. doi: 10.3332/ecancer.2019.927.
  2. Ostapenko E, Nixdorf L, Devyatko Y et al. Prepectoral versus subpectoral implantbased breast reconstruction: a systemic review and meta-analysis. Ann Surg Oncol 2023; 30(1): 126–136. doi: 10.1245/ s10434-022-12567-0.
  3. Stillaert F, Lannau B, Van Landuyt K et al. The prepectoral, hybrid breast reconstruction: the synergy of lipofilling and breast implants. Plast Reconstr Surg Glob Open 2020; 8(7): e2966. doi: 10.1097/GOX.0000000000002966.
  4. Kolasinski J, Pyka P. Fat grafting following internal tissue expansion: an option for breast reconstruction after total mastectomy. Plast Reconstr Surg Glob Open 2022; 10(2): e4088. doi: 10.1097/ GOX.0000000000004088.
  5. Mu X, Zhang J, Jiang Y. 3D printing in breast reconstruction: from bench to bed. Front Surg 2021; 8: 641370. doi: 10.3389/ fsurg.2021.641370.
  6. Moroni S, Casettari L, Lamprou DA. 3D and 4D printing in the fight against breast cancer. Biosensors (Basel) 2022; 12(8): 568. doi: 10.3390/bios12080568.
  7. Galimberti V, Cole BF, Viale G et al. Axillary dissection versus no axillary dissection in patients with breast cancer and sentinelnode micrometastases (IBCSG 23-01): 10-year follow-up of a randomised, controlled phase 3 trial. Lancet Oncol 2018; 19(10): 1385–1393. doi: 10.1016/ S1470-2045(18)30380-2.
  8. Huang TW, Su CM, Tam KW. Axillary management in women with early breast cancer and limited sentinel node metastasis: a systematic review and metaanalysis of real-world evidence in the post-ACOSOG Z0011 era. Ann Surg Oncol 2021; 28(2): 920–929. doi: 10.1245/ s10434-020-08923-7.
  9. Bartels SAL, Donker M, Poncet C et al. Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer: 10-year results of the randomized controlled EORTC 10981-22023 AMAROS trial. J Clin Oncol 2023; 41(12): 2159–2165. doi: 10.1200/JCO.22.01565.
  10. Susini T, Nesi I, Renda I et al. Reducing the use of frozen section for sentinel node biopsy in breast carcinoma: feasibility and outcome. Anticancer Res 2023; 43(5): 2161–2170. doi: 10.21873/anticanres.16378.
  11. Caudle AS, Yang WT, Krishnamurthy S et al. Improved axillary evaluation following neoadjuvant therapy for patients with node-positive breast cancer using selective evaluation of clipped nodes: implementation of targeted axillary dissection. J Clin Oncol 2016; 34(10): 1072–1078. doi: 10.1200/JCO.2015.64.0094.
  12. Swarnkar PK, Tayeh S, Michell MJ et al. The evolving role of marked lymph node biopsy (MLNB) and targeted axillary dissection (TAD) after neoadjuvant chemotherapy (NACT) for nodepositive breast cancer: systematic review and pooled analysis. Cancers (Basel) 2021; 13(7): 1539. doi: 10.3390/cancers13071539.
  13. Žatecký J, Coufal O, Zapletal O et al. Ideal marker for targeted axillary dissection (IMTAD): a prospective multicentre trial. World J Surg Oncol 2023; 21(1): 252. doi: 10.1186/s12957-023-03147-x.
  14. Kontos M, Kanavidis P, Kühn T et al. Targeted axillary dissection: worldwide variations in clinical practice. Breast Cancer Res Treat 2024; 204(2): 389–396. doi: 10.1007/s10549-023-07204-7.
  15. Samiei S, Simons JM, Engelen S et al. Axillary pathologic complete response after neoadjuvant systemic therapy by breast cancer subtype in patients with initially clinically node-positive disease: a systematic review and meta-analysis. JAMA Surg 2021; 156(6): e210891. doi: 10.1001/jamasurg.2021.0891.
  16. Abdelfattah U, Pons G, Masià J. Evaluating the impact of immediate lymphatic reconstruction for the surgical prevention of lymphedema. Plast Reconstr Surg 2023; 151(3): 522e–523e. doi: 10.1097/ PRS.0000000000009942.
  17. Pons G, Tang JB. Major changes in lymphatic microsurgery and microvascular surgery in past 20 years. Clin Plast Surg 2020; 47(4): 679–683. doi: 10.1016/j.cps.2020. 07. 004.
  18. Kastora SL, Holmquist A, Valachis A et al. Outcomes of different quality of life assessment modalities after breast cancer therapy: a network meta-analysis. JAMA Netw Open 2023; 6(6): e2316878. doi: 10.1001/jamanetworkopen.2023.16878.
  19. Saunders CM. Breast surgery: a narrative review. Med J Aust 2022; 217(5): 262–267. doi: 10.5694/mja2.51678.

MUDr. Zuzana Chaloupková
Oddělení mamokutánní a onkoplastické chirurgie
Klinika operační onkologie MOÚ
Žlutý kopec 7
656 53 Brno
zuzana.chaloupkova@mou.cz

ORCID autorů
Z. Chaloupková 0009-0000-5564-7424
O. Coufal 0000-0002-8600-8606

Štítky
Surgery Orthopaedics Trauma surgery
Článek Tradiční Rozhledy v novém
Článek Budoucnost mamologie
Článek Surgical treatment of breast cancer associated with pregnancy and lactation
Článek Breast cancer in 80+ year olds
Článek Breast cancer localization by iodine seed 125I vs. wire- -guided localization – retrospective case-control study
Článek Surgical treatment of breast precancers – our experience
Článek The variable histogenesis and biology of selected bland fibroblastic lesions of the breast – pitfalls in the differential diagnostics and optimal therapeutic approach (three case reports)
Článok vyšiel v časopise

Perspectives in Surgery

Číslo 7
2024 Číslo 7
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#