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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Object],[object Object],Clough 2003, Kaur 2005, Rietjens 2007, Fitoussi 2010 ,[object Object],2010, 1215 cases BCT, unpublished data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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Plus de European School of Oncology (20)

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ABC1 - X. Zhang - Metastasis seed pre-selection driven by the microenvironmen...ABC1 - X. Zhang - Metastasis seed pre-selection driven by the microenvironmen...
ABC1 - X. Zhang - Metastasis seed pre-selection driven by the microenvironmen...
 
G. Ceresoli - Prostate and renal cancer - State of the art and update on syst...
G. Ceresoli - Prostate and renal cancer - State of the art and update on syst...G. Ceresoli - Prostate and renal cancer - State of the art and update on syst...
G. Ceresoli - Prostate and renal cancer - State of the art and update on syst...
 
A. Shamseddine - Prostate and renal cancer - State of the art and update on s...
A. Shamseddine - Prostate and renal cancer - State of the art and update on s...A. Shamseddine - Prostate and renal cancer - State of the art and update on s...
A. Shamseddine - Prostate and renal cancer - State of the art and update on s...
 
W. Hassen - Bladder cancer - Guidelines
W. Hassen - Bladder cancer - GuidelinesW. Hassen - Bladder cancer - Guidelines
W. Hassen - Bladder cancer - Guidelines
 
A. Stathis - New drugs in the treatment of lymphomas
A. Stathis - New drugs in the treatment of lymphomasA. Stathis - New drugs in the treatment of lymphomas
A. Stathis - New drugs in the treatment of lymphomas
 
H. Khaled - Bladder cancer - State of the art
H. Khaled - Bladder cancer - State of the artH. Khaled - Bladder cancer - State of the art
H. Khaled - Bladder cancer - State of the art
 
A. Stathis - Lymphomas - New drugs in the treatment of lymphomas
A. Stathis - Lymphomas - New drugs in the treatment of lymphomasA. Stathis - Lymphomas - New drugs in the treatment of lymphomas
A. Stathis - Lymphomas - New drugs in the treatment of lymphomas
 
1 azim
1 azim1 azim
1 azim
 
H. Azim - Lymphomas - State of the art
H. Azim - Lymphomas - State of the artH. Azim - Lymphomas - State of the art
H. Azim - Lymphomas - State of the art
 
S. Khleif - Ovarian cancer - General lecture on vaccine
S. Khleif - Ovarian cancer - General lecture on vaccineS. Khleif - Ovarian cancer - General lecture on vaccine
S. Khleif - Ovarian cancer - General lecture on vaccine
 
A. Hassan - Ovarian cancer - Guidelines and clinical case presentation (2-3 c...
A. Hassan - Ovarian cancer - Guidelines and clinical case presentation (2-3 c...A. Hassan - Ovarian cancer - Guidelines and clinical case presentation (2-3 c...
A. Hassan - Ovarian cancer - Guidelines and clinical case presentation (2-3 c...
 
J.B. Vermorken - Ovarian cancer - State of the art
J.B. Vermorken - Ovarian cancer - State of the artJ.B. Vermorken - Ovarian cancer - State of the art
J.B. Vermorken - Ovarian cancer - State of the art
 
A. Hassan - Cervical cancer - Guidelines and clinical case presentation (2-3 ...
A. Hassan - Cervical cancer - Guidelines and clinical case presentation (2-3 ...A. Hassan - Cervical cancer - Guidelines and clinical case presentation (2-3 ...
A. Hassan - Cervical cancer - Guidelines and clinical case presentation (2-3 ...
 
V. Kesic - Cervical cancer - State of the art
V. Kesic - Cervical cancer - State of the art V. Kesic - Cervical cancer - State of the art
V. Kesic - Cervical cancer - State of the art
 
T. Cufer - Breast cancer - State of the art for advanced breast cancer
T. Cufer - Breast cancer - State of the art for advanced breast cancer T. Cufer - Breast cancer - State of the art for advanced breast cancer
T. Cufer - Breast cancer - State of the art for advanced breast cancer
 
N. El Saghir - Breast cancer - State of the art for early breast cancer
N. El Saghir - Breast cancer - State of the art for early breast cancerN. El Saghir - Breast cancer - State of the art for early breast cancer
N. El Saghir - Breast cancer - State of the art for early breast cancer
 
S. Cascinu - Liver/Hepatobiliary - State of the art
S. Cascinu - Liver/Hepatobiliary - State of the artS. Cascinu - Liver/Hepatobiliary - State of the art
S. Cascinu - Liver/Hepatobiliary - State of the art
 
S. Cascinu - Colorectal cancer - Guidelines and clinical case presentation (2...
S. Cascinu - Colorectal cancer - Guidelines and clinical case presentation (2...S. Cascinu - Colorectal cancer - Guidelines and clinical case presentation (2...
S. Cascinu - Colorectal cancer - Guidelines and clinical case presentation (2...
 
G. Pentheroudakis - Colorectal cancer - State of the art
G. Pentheroudakis - Colorectal cancer - State of the artG. Pentheroudakis - Colorectal cancer - State of the art
G. Pentheroudakis - Colorectal cancer - State of the art
 
A. Tfayli - Head and neck - Guidelines and clinical case presentation (2-3 ca...
A. Tfayli - Head and neck - Guidelines and clinical case presentation (2-3 ca...A. Tfayli - Head and neck - Guidelines and clinical case presentation (2-3 ca...
A. Tfayli - Head and neck - Guidelines and clinical case presentation (2-3 ca...
 

EASO2011 BRS 6 Clough