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EASO2011 BRS 6 Clough

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European School of Oncology
European School of Oncology
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ONCOPLASTIC SURGERY Level 1 techniques : Simple principles Krishna B. CLOUGH, Claude NOS, Isabelle SARFATI
ONCOPLASTIC SURGERY ,[object Object],[object Object],[object Object],[object Object],Plastic surgery techniques at the time of tumor excision Audretsch, Clough, Petit, Rainsbury ,...
ONCOPLASTIC SURGERY CLASSIFICATION Ann Surg Oncol 2010
ONCOPLASTIC SURGERY : A CLASSIFICATION ,[object Object],[object Object],[object Object],[object Object],[object Object],Avoids deformities
ONCOPLASTIC SURGERY : A CLASSIFICATION ,[object Object],[object Object],[object Object],[object Object],[object Object],Increase breast conservation rates
" LEVEL 1 "   ONCOPLASTIC TECHNIQUES ,[object Object],[object Object],[object Object],« Learn on Tuesday, Try on Thursday Keep forever »  
BREAST CONSERVATION: DILEMMNA ,[object Object],[object Object],[object Object],[object Object]
CONSERVATIVE SURGERY : A CLASH OF INTERESTS
 
INVOLVED MARGINS ,[object Object],[object Object],[object Object],[object Object]
“ RED ZONES "
LEVEL 1 OPS GENERAL PRINCIPLES ,[object Object],[object Object],[object Object],[object Object],[object Object]
SKIN UNDERMNING
SKIN UNDERMINING
BREAST DENSITY : BIRADS CLASSIFICATION 1 2 3 4
NAC UNDERMINING
NAC UNDERMINING
NAC UNDERMINING
WIDE EXCISION FROM SKIN TO MUSCLE
POSITIVE MARGINS FOR BCT ,[object Object],[object Object],Clough 2003, Kaur 2005, Rietjens 2007, Fitoussi 2010 ,[object Object],2010, 1215 cases BCT, unpublished data
WIDE EXCISION
BREAST RESHAPING ?
BREAST RESHAPING : GLANDULAR FLAPS
GLANDULAR FLAPS
GLANDULAR FLAPS
GLANDULAR SUTURE
ROTATIONAL GLANDULAR FLAPS
ROTATIONAL GLANDULAR FLAP
ROTATIONAL GLANDULAR FLAP
PREVENT NAC DEVIATION ? RE-CENTRALIZATION
NAC RE-CENTRALIZATION ,[object Object]
 
 
Upper inner Q Upper outer Q
BCT FOR SUBAREOLAR CANCERS
WIDE CENTRAL EXCISION : RESHAPING
WIDE CENTRAL EXCISION : RESHAPING
 
 
 
 
 
 
PARIS BREAST CENTER ,[object Object],[object Object],[object Object],[object Object],[object Object],90% Oncoplastic surgery level 1
ONCOPLASTIC SURGERY From CHILDHOOD TO ADOLESCENCE ? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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EASO2011 BRS 6 Clough