Surgery and Reconstruction for Breast Cancer Flashcards
What are the types of breast conservation?
lumpectomy; wide local excision; wire guided local excision and oncoplastic breast conservation
What are the types of masectomy?
traditional transverse and skin sparing with immediate reconstruction
what needs to happen to ensure breast conservation is equivalent in disease free and overall survival to mastectomy?
clear margins >=1mm and breast radiotherapy
What is the surgical wide excision defined as?
1cm excision at all margins
How is excision of impalpable lesions carried out?
using a specimen xray
What is the standard chemotherapy used neoadjuvantly?
standard FEC100 and taxane
What are the options for endocrine therapy?
aromatase inhibitors; tamoxifen
What is the difference in efficacy between aromatase inhibitors and tamoxifen?
aromatase inhibitors are more effective
What is oncoplastic surgery?
safe oncological surgery while avoiding tissue deformity- resahpe breast contours at time of cancer resection
What is oncoplastic breast conservation for large breast or large tumour?
therapeutic mammoplasty
What oncoplastic technqiue is used for small breasts?
volume replacement techniques
What are the reconstruction options after mastectomy?
implant only; latissimus dorsi pedicled flap; deep inferior epigastric artery perforator free flap or inferior gluteal artery perforator free flap
What are the problems with implant based reconstruction?
loss of implants (infection); capsular contracture; implant rippling or migration
What percentage of implant based reconstructions require revisional surgery?
40%
What is the 1st stage of 2 stage implant reconstruction?
1st- mastectomy and creation of submuscular pocket with expander insertion
