Publication details

Onkoplastická chirurgie karcinomu prsu – využití okamžité rekonstrukce: 2016-2020

Title in English Breast cancer oncoplasty surgery - use of immediate reconstruction: 2016-2020


Year of publication 2021
Type Conference abstract
MU Faculty or unit

Faculty of Medicine

Description Oncoplastic surgery has expanded the possibilities of breast surgery, enabling procedures that are sufficiently radical and yet with a very good cosmetic effect. With the development of genetic testing programs, the need for prophylactic procedures in mutated patients, as well as healthy carriers, is growing. We use subcutaneous mastectomy with immediate reconstruction in healthy patients with BRCA mutations, as well as in patients with precancerous lesions (DCIS G I and II). In patients with DCIS G3 and invasive tumors of size T1 mastectomy with implant reconstruction. For tumors more advanced or after non-adjuvant oncological treatment, we perform expander insertion after mastectomy and axillary surgery with completion of breast modeling and replacement of expanders with implants in the second period. In breast cancer, where the BRCA mutation is also detected, we perform a combined procedure in several steps, primarily with the resolution of the detected malignancy and in the second period a prophylactic procedure on the second healthy breast, simultaneously with prophylactic adnexectomy. In the period September 2016 - May 2020, we performed 97 mammary reconstruction operations. Of these, 65 procedures in patients with BRCA mutation and / or early stage breast cancer were treated with immediate reconstruction mastectomy. Only implants (in one or both breasts) were used in 53 cases. Reconstruction of own tissues was performed in 12 operations (fasciocutaneous or musculocutaneous lobe without the use of an implant). In 32 women with locally advanced breast tumors with the need for subsequent radiotherapy, an expander was inserted at first, which was gradually replaced by an implant. All patients are still alive. Complications of performance were in 8 women. Patients continue to be monitored by an oncologist. Breast reconstruction is a comprehensive set of techniques by which any patient can create a breast with which she would be satisfied. However, it is a multi-stage process and extensive performance with high and time-consuming healing. It is important to include the correct time in the overall anti-cancer treatment plan to avoid unnecessary delays in chemotherapy and radiotherapy, but also in surgery.

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