Clinical efficacy of volume displacement techniques for breast defects following breast conserving surgery_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

XU Bo ,  ZHENG Jingzhou , ZHANG Ze

1. Department of Thyroid and Breast Surgery, Minda Hospital of Hubei Minzu University, Enshi, Hubei 445000, P. R. China;

Corresponding?author：

ZHENG Jingzhou, Email: 326542951@qq.com

Keywords：

volume displacement technique; breast conserving surgery; breast cancer; breast defect; prognosis

DOI：

10.7507/1007-9424.202308001

Video：

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Objective To explore the clinical efficacy of volume displacement techniques for breast defects following breast conserving surgery. Methods After inclusion and exclusion, the patients with breast defects following breast conserving surgery in the Minda Hospital of Hubei Minzu University from February 2013 to March 2020 were retrospectively enrolled, and were assigned into a volume displacement group and volume replacement group according to different surgical techniques. Then the outcomes were compared between the two groups, including short-term efficacy (incision length, operation time, intraoperative blood loss, volume of resected specimen, cosmetic effect, patients’ subjective satisfaction, total postoperative complications, and total hospitalization time) and long-term efficacy (local recurrence rate, 3-year tumor-free survival, and 3-year overall survival). Results A total of 208 eligible patients were included in this study, including 105 in the volume displacement group and 103 in the volume replacement group before propensity score matching (PSM); after PMS, a total of 62 patients were enrolled, including 33 in the volume displacement group and 29 in the volume replacement group. No statistical difference was reported in the baseline data between two groups (P>0.05), except that the maximum diameter of lesion in the volume displacement group was smaller than that in the volume replacement group (P<0.05). The incision length, operation time, total hospitalization time, total postoperative complication rate, local recurrence rate, 3-year tumor-free survival rate, and 3-year overall survival rate had no statistical differences between the two groups (P>0.05), whereas the intraoperative blood loss was less (t=3.294, P=0.002) and the volume of resected specimen was smaller (t=2.030, P=0.047) in the volume displacement group as compared with the volume replacement group, and the cosmetic effect and patients’ subjective satisfaction were better in the volume displacement group as compared with the volume replacement group (Z=2.297, P=0.022; Z=2.256, P=0.024). Conclusion The study analysis with small size samples reveals that volume displacement technique for breast defects following breast conserving surgery can achieve a good cosmetic effect and high patients’ subjective satisfaction without increasing risk of postoperative complications and tumour recurrence, which demonstrates a good long-term efficacy profile.

Citation： XU Bo, ZHENG Jingzhou, ZHANG Ze. Clinical efficacy of volume displacement techniques for breast defects following breast conserving surgery. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(1): 74-79. doi: 10.7507/1007-9424.202308001 Copy

1.	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2.	馬天怡, 王海波. 腫瘤整形技術在保乳手術中的應用與進展. 臨床外科雜志, 2021, 29(3): 215-217.
3.	Clough KB, Kaufman GJ, Nos C, et al. Improving breast cancer surgery: a classification and quadrant per quadrant atlas for oncoplastic surgery. Ann Surg Oncol, 2010, 17(5): 1375-1391.
4.	任敏, 徐云鳳. 乳腺癌乳房成形手術方法的精準選擇. 臨床外科雜志, 2021, 29(3): 222-225.
5.	沈浩元, 胡超華. 乳腺癌外科治療十大熱點. 臨床外科雜志, 2023, 31(1): 97-100.
6.	胡震. 保乳整形手術中的容量移位技術. 中國實用外科雜志, 2019, 39(11): 1231-1234.
7.	Jin S, Xu B, Shan M, et al. Clinical significance of oncoplastic breast-conserving surgery and application of volume-displacement technique. Ann Plast Surg, 2021, 86(2): 233-236.
8.	中國抗癌協會乳腺癌專業委員會. 中國抗癌協會乳腺癌診治指南與規范(2021年版). 中國癌癥雜志, 2021, 31(10): 954-1040.
9.	Kanatas A, Velikova G, Roe B, et al. Patient-reported outcomes in breast oncology: a review of validated outcome instruments. Tumori, 2012, 98(6): 678-688.
10.	中華人民共和國衛生部醫政司, 中華人民共和國衛生部辦公廳. 乳腺癌診療規范(2011年版). 中國實用外科雜志, 2011, 31(10): 902-907.
11.	徐其, 徐丹英, 劉月, 等. 容量移位法保乳整形術在早期乳腺癌患者中的應用效果觀察. 浙江醫學, 2022, 44(24): 2631-2634.
12.	陳志強, 凌煜瑋, 康驊. 早期乳腺癌保留乳房手術中的組織缺損修復. 中華乳腺病雜志(電子版), 2021, 15(3): 169-173.
13.	Blok YL, Verduijn PS, Corion LUM, et al. An analysis of complication rates and the influence on patient satisfaction and cosmetic outcomes following oncoplastic breast surgery. J Plast Reconstr Aesthet Surg, 2022, 75(11): 4152-4159.
14.	Wang X, Mathews A, Erickson A, et al. Single center oncoplastic experience and patient satisfaction reported via patient reported outcomes. Plast Reconstr Surg Glob Open, 2022, 10(5): e4336.
15.	沈裕厚, 岳愛民, 尹宏達, 等. 腫瘤整形技術在乳腺癌保乳手術中的臨床應用. 中國普通外科雜志, 2022, 31(5): 577-586.
16.	魏余賢, 張翔, 厲紅元. 合理應用腫瘤整形外科技術. 中華內分泌外科雜志, 2022, 16(5): 513-515.
17.	任嘉輝, 唐仁檄, 楊玲, 等. 腫瘤整形保留乳房手術的臨床應用. 中華乳腺病雜志(電子版), 2023, 17(3): 172-178.
18.	Crown A, Carlson E, Rocha FG, et al. Oncoplastic breast-conserving therapy and intraoperative radiotherapy for management of carcinoma in situ of the breast: a single-center experience. Breast J, 2020, 26(12): 2391-2394.
19.	Barellini L, Marcasciano M, Lo Torto F, et al. Intraoperative ultrasound and oncoplastic combined approach: an additional tool for the oncoplastic surgeon to obtain tumor-free margins in breast conservative surgery—A 2-year single-center prospective study. Clin Breast Cancer, 2020, 20(3): e290-e294.
20.	Rose M, Svensson H, Handler J, et al. Patient-reported outcome after oncoplastic breast surgery compared with conventional breast-conserving surgery in breast cancer. Breast Cancer Res Treat, 2020, 180(1): 247-256.
21.	van la Parra RFD, Clough KB, Thygesen HH, et al. Oncological safety of oncoplastic level Ⅱ mammoplasties after neoadjuvant chemotherapy for large breast cancers: a matched-cohort analysis. Ann Surg Oncol, 2021, 28(11): 5920-5928.
22.	張宏旭, 劉海旺, 胡大為, 等. 超聲引導下染色劑標記切緣在早期乳腺癌保乳手術中的應用效果研究. 中國現代醫學雜志, 2022, 32(2): 92-96.
23.	Salibian AA, Olson B, Shauly O, et al. Oncoplastic breast reconstruction: principles, current techniques, and future directions. J Surg Oncol, 2022, 126(3): 450-459.
24.	呂民豪, 喬江華, 李軍濤, 等. 新輔助化療后乳腺癌保乳手術中利用腫瘤整形技術的臨床應用效果. 中國普外基礎與臨床雜志, 2019, 26(6): 678-684.
25.	Schaverien MV, Robb G, Smith B. Reply: Outcomes of volume replacement oncoplastic breast-conserving surgery using chest wall perforator flaps: comparison with volume displacement oncoplastic surgery and total breast reconstruction. Plast Reconstr Surg, 2021, 147(6): 1058e-1059e.

1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2. 馬天怡, 王海波. 腫瘤整形技術在保乳手術中的應用與進展. 臨床外科雜志, 2021, 29(3): 215-217.
3. Clough KB, Kaufman GJ, Nos C, et al. Improving breast cancer surgery: a classification and quadrant per quadrant atlas for oncoplastic surgery. Ann Surg Oncol, 2010, 17(5): 1375-1391.
4. 任敏, 徐云鳳. 乳腺癌乳房成形手術方法的精準選擇. 臨床外科雜志, 2021, 29(3): 222-225.
5. 沈浩元, 胡超華. 乳腺癌外科治療十大熱點. 臨床外科雜志, 2023, 31(1): 97-100.
6. 胡震. 保乳整形手術中的容量移位技術. 中國實用外科雜志, 2019, 39(11): 1231-1234.
7. Jin S, Xu B, Shan M, et al. Clinical significance of oncoplastic breast-conserving surgery and application of volume-displacement technique. Ann Plast Surg, 2021, 86(2): 233-236.
8. 中國抗癌協會乳腺癌專業委員會. 中國抗癌協會乳腺癌診治指南與規范(2021年版). 中國癌癥雜志, 2021, 31(10): 954-1040.
9. Kanatas A, Velikova G, Roe B, et al. Patient-reported outcomes in breast oncology: a review of validated outcome instruments. Tumori, 2012, 98(6): 678-688.
10. 中華人民共和國衛生部醫政司, 中華人民共和國衛生部辦公廳. 乳腺癌診療規范(2011年版). 中國實用外科雜志, 2011, 31(10): 902-907.
11. 徐其, 徐丹英, 劉月, 等. 容量移位法保乳整形術在早期乳腺癌患者中的應用效果觀察. 浙江醫學, 2022, 44(24): 2631-2634.
12. 陳志強, 凌煜瑋, 康驊. 早期乳腺癌保留乳房手術中的組織缺損修復. 中華乳腺病雜志(電子版), 2021, 15(3): 169-173.
13. Blok YL, Verduijn PS, Corion LUM, et al. An analysis of complication rates and the influence on patient satisfaction and cosmetic outcomes following oncoplastic breast surgery. J Plast Reconstr Aesthet Surg, 2022, 75(11): 4152-4159.
14. Wang X, Mathews A, Erickson A, et al. Single center oncoplastic experience and patient satisfaction reported via patient reported outcomes. Plast Reconstr Surg Glob Open, 2022, 10(5): e4336.
15. 沈裕厚, 岳愛民, 尹宏達, 等. 腫瘤整形技術在乳腺癌保乳手術中的臨床應用. 中國普通外科雜志, 2022, 31(5): 577-586.
16. 魏余賢, 張翔, 厲紅元. 合理應用腫瘤整形外科技術. 中華內分泌外科雜志, 2022, 16(5): 513-515.
17. 任嘉輝, 唐仁檄, 楊玲, 等. 腫瘤整形保留乳房手術的臨床應用. 中華乳腺病雜志(電子版), 2023, 17(3): 172-178.
18. Crown A, Carlson E, Rocha FG, et al. Oncoplastic breast-conserving therapy and intraoperative radiotherapy for management of carcinoma in situ of the breast: a single-center experience. Breast J, 2020, 26(12): 2391-2394.
19. Barellini L, Marcasciano M, Lo Torto F, et al. Intraoperative ultrasound and oncoplastic combined approach: an additional tool for the oncoplastic surgeon to obtain tumor-free margins in breast conservative surgery—A 2-year single-center prospective study. Clin Breast Cancer, 2020, 20(3): e290-e294.
20. Rose M, Svensson H, Handler J, et al. Patient-reported outcome after oncoplastic breast surgery compared with conventional breast-conserving surgery in breast cancer. Breast Cancer Res Treat, 2020, 180(1): 247-256.
21. van la Parra RFD, Clough KB, Thygesen HH, et al. Oncological safety of oncoplastic level Ⅱ mammoplasties after neoadjuvant chemotherapy for large breast cancers: a matched-cohort analysis. Ann Surg Oncol, 2021, 28(11): 5920-5928.
22. 張宏旭, 劉海旺, 胡大為, 等. 超聲引導下染色劑標記切緣在早期乳腺癌保乳手術中的應用效果研究. 中國現代醫學雜志, 2022, 32(2): 92-96.
23. Salibian AA, Olson B, Shauly O, et al. Oncoplastic breast reconstruction: principles, current techniques, and future directions. J Surg Oncol, 2022, 126(3): 450-459.
24. 呂民豪, 喬江華, 李軍濤, 等. 新輔助化療后乳腺癌保乳手術中利用腫瘤整形技術的臨床應用效果. 中國普外基礎與臨床雜志, 2019, 26(6): 678-684.
25. Schaverien MV, Robb G, Smith B. Reply: Outcomes of volume replacement oncoplastic breast-conserving surgery using chest wall perforator flaps: comparison with volume displacement oncoplastic surgery and total breast reconstruction. Plast Reconstr Surg, 2021, 147(6): 1058e-1059e.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical efficacy of volume displacement techniques for breast defects following breast conserving surgery

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