title: [Oncoplastic breast surgery for the management of ductal carcinoma in situ].
abstract: DCIS (Ductal carcinoma in situ) constitutes 15,2% of breast cancers. Conservative surgery coupled with adjuvant radiotherapy is often recommended. The rate of revision surgery is high, from 30 to 60%. The concern is a high quality resection within clear margins with a satisfactory aesthetic result. The objective of this review is to precise the place of oncoplastic surgery in DCIS care. Among risk factors of recurrence, tumoral invasion of surgical margins is capital. In histology, clear margins usually adopted for DCIS are 2mm, even though there is no international consensus. Recent studies show that a 10mm limit would be better. Aesthetic damage caused by surgery, often increased by radiotherapy, has a negative impact on women quality of life: oncoplastic surgery may minimize it. Techniques of plastic surgery, arranged into level 1 and 2, allow pushing back conservative treatment limits by removing a larger tumor with clear margins. Often used in invasive cancers, few data exist regarding oncoplastic surgery and DCIS. It allows to increase the dimensions of surgical resection by 20% and to decrease positive margins significantly therefore the rate of revision surgeries. Patients are satisfied with it. Specific indications need to be clarified according to age, size and "comedonecrosis" presence. Oncoplastic surgery should be developed in DCIS specific care.
authors.affiliation: Clinique de chirurgie gynécologique, hôpital Jeanne-de-Flandre, CHRU de Lille, université Lille Nord de France, 2, avenue Eugene-Aviné, 59000 Lille, France. Electronic address: azais.ju@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Bauwens
authors.affiliation: Clinique de chirurgie gynécologique, hôpital Jeanne-de-Flandre, CHRU de Lille, université Lille Nord de France, 2, avenue Eugene-Aviné, 59000 Lille, France.
authors.forename: H
authors.initials: H
authors.lastname: Azaïs
authors.affiliation: Maternité Monaco, avenue Monaco, 59300 Valenciennes, France.
authors.forename: P
authors.initials: P
authors.lastname: Devouge
authors.affiliation: Maternité Monaco, avenue Monaco, 59300 Valenciennes, France.
authors.forename: J
authors.initials: J
authors.lastname: Phalippou
authors.affiliation: Clinique de chirurgie gynécologique, hôpital Jeanne-de-Flandre, CHRU de Lille, université Lille Nord de France, 2, avenue Eugene-Aviné, 59000 Lille, France.
authors.forename: L
authors.initials: L
authors.lastname: Boulanger
authors.affiliation: Clinique de chirurgie gynécologique, hôpital Jeanne-de-Flandre, CHRU de Lille, université Lille Nord de France, 2, avenue Eugene-Aviné, 59000 Lille, France.
authors.forename: P
authors.initials: P
authors.lastname: Collinet
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000601:surgery*; D005260:Female; D006801:Humans; D000072662:Margins of Excision; D008408:Mastectomy / Q000379:methods; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D018714:Radiotherapy, Adjuvant; D019651:Plastic Surgery Procedures; D012086:Reoperation; D012307:Risk Factors
keywords: Breast Cancer; Cancer du sein; Carcinome canalaire in situ; Clear margin; Conservative surgery; Ductal carcinoma in situ; Marge d’exérèse saine; Oncoplastic surgery; Oncoplastie; Traitement chirurgical conservateur