title: Outcome of different oncoplastic surgical (OPs) techniques for centrally located breast cancer (CLBC).
abstract: BACKGROUND
  Oncoplastic breast surgery is a standard treatment of early breast cancer, offering a balance between good cosmetic outcome and limited risk of locoregional recurrence, by enabling proper resection margins.
  
  
  OBJECTIVE
  To present multiple techniques of partial breast reconstruction following the resection of centrally located breast cancer (CLBC) resection.
  
  
  METHODS
  From January 2011 to August 2014, 21 patients underwent central quadrantectomy for carcinoma of the central region of the breast. Excisions included the nipple/areola complex, in most of the cases, down to the pectoralis fascia with a wide safety margin, and proper axillary management. Oncoplastic approaches included latissimus dorsi flap, inferior pedicle flap, Melon slice, Grisotti and round block techniques.
  
  
  RESULTS
  Mean age of patients was 49.5±10.61 years. Tumor size ranged from 1.5 to 4.5 cm. Postoperative pathology revealed a tumor mean safety margin of 2.5±0.83 cm, with positive axillary lymph nodes in 15 (75.0%) patients. Nineteen (95.0%) patients received postoperative breast radiotherapy, while 9/20 (45.0%) and 3/20 (15.0%) received adjuvant chemotherapy or hormonal therapy, respectively, and only 8/20 (40.0%) patients received both therapies. During a median follow-up period of 14.89 months, neither local nor distant metastasis, were detected. The postoperative cosmetic result evaluated by the patients was excellent in 6/20 patients (30.0%), good in 11/20 patients (55.0%), fair in 3/20 (15.0%) with neither poor nor bad results, with an overall mean of 4.0±0.5 equivalent to 80% satisfaction.
  
  
  CONCLUSIONS
  Multiple oncoplastic breast surgery techniques can be used for the resection of CLBC with satisfying cosmetic outcomes.
authors.affiliation: Surgical Oncology Department, National Cancer Institute (NCI), Cairo University, Egypt.
authors.forename: A
authors.initials: A
authors.lastname: Moustafa
authors.affiliation: Surgical Oncology Department, National Cancer Institute (NCI), Cairo University, Egypt. Electronic address: ibrahim.fakhr@nci.cu.edu.eg.
authors.forename: I
authors.initials: I
authors.lastname: Fakhr
mesh_terms: D000328:Adult; D001940:Breast / Q000601:surgery; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery; D009558:Nipples / Q000601:surgery; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps; D013514:Surgical Procedures, Operative; D016896:Treatment Outcome
keywords: Central breast cancer; Grisotti procedure; Inferior pedicle flap; Latissimus dorsi (LD) flap; Melon slice; Oncoplastic breast surgery (OBS); Round block technique (Donut Mastopexy Resection)