title: Oncoplastic breast conserving surgery: Volume replacement vs. volume displacement.
abstract: Oncoplastic breast conserving surgery (BCS) has emerged as a third option between conventional BCS and mastectomy. Oncoplastic BCS includes two fundamentally different approaches: volume replacement and volume displacement. The former involves partial mastectomy and immediate reconstruction of the breast with the transposition of autologous tissue from elsewhere, while the latter involves partial mastectomy and using the remaining breast tissue to fill the defect resulting from extirpation of the tumor. There are several benefits associated with oncoplastic BCS. First, it allows partial mastectomy without cosmetic penalties, and can achieve better cosmetic outcomes than total mastectomy with immediate breast reconstruction. Second, it avoids the need for total mastectomy in an increasing number of patients without compromising local control. Third, partial breast reconstruction is less extensive and has fewer complications than conventional procedures. Partial mastectomy and partial breast reconstruction can be carried out either simultaneously as a one-stage procedure, or using a two-stage approach. Although patients prefer a one-stage procedure, it requires intraoperative confirmation of complete tumor excision using frozen-section analysis. Moreover, oncoplastic BCS requires combined skills, knowledge, and understanding of both oncological and plastic surgeries, which may be optimally achieved by an oncoplastic surgeon.
authors.affiliation: Department of Breast and Endocrine Surgery, Kanazawa Medical University Hospital, Uchinada-daigaku, Ishikawa, Japan. Electronic address: nogumasa@kanazawa-med.ac.jp.
authors.forename: M
authors.initials: M
authors.lastname: Noguchi
authors.affiliation: Department of Breast and Endocrine Surgery, Kanazawa Medical University Hospital, Uchinada-daigaku, Ishikawa, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Yokoi-Noguchi
authors.affiliation: Department of Breast and Endocrine Surgery, Kanazawa Medical University Hospital, Uchinada-daigaku, Ishikawa, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Ohno
authors.affiliation: Department of Breast and Endocrine Surgery, Kanazawa Medical University Hospital, Uchinada-daigaku, Ishikawa, Japan.
authors.forename: E
authors.initials: E
authors.lastname: Morioka
authors.affiliation: Department of Breast and Endocrine Surgery, Kanazawa Medical University Hospital, Uchinada-daigaku, Ishikawa, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Nakano
authors.affiliation: Department of Surgical Oncology, Kanazawa Medical University Hospital, Uchinada-daigaku, Ishikawa, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kosaka
authors.affiliation: Breast Center, Yale Cancer Center, New Haven, CT, USA.
authors.forename: T
authors.initials: T
authors.lastname: Kurita
mesh_terms: D001940:Breast; D001943:Breast Neoplasms; D006801:Humans; D016462:Mammaplasty; D008408:Mastectomy; D015412:Mastectomy, Segmental
keywords: Breast reconstruction; Breast surgery; Mammoplasty; Segmental mastectomy