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Oncoplastic breast reconstruction: An evaluation of the University of Pittsburgh Department of Plastic Surgery experience

Edward Ruane, MD; Vu Nguyen, MD; Carolyn De La Cruz, MD; Michael Gimbel, MD
University of Pittsburgh Medical Center
2014-03-15

Presenter: Edward Ruane

Affidavit:
The above work is the original work of Edward Ruane.

Director Name: Joseph Losee

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)

Oncoplastic breast reconstruction (OBR) is a relatively recent addition to the arsenal of techniques used by reconstructive surgeons. Various methods of OBR have been utilized by University of Pittsburgh Department of Plastic Surgery faculty. The purpose of this study is to retrospectively analyze the University of Pittsburgh Department of Plastic Surgery experience with OBR.

A retrospective review was performed on all patients who underwent OBR by three reconstructive breast surgeons at our institution between April 2007 and January 2013. Descriptive statistics and multivariate analysis were utilized.

A total of 28 women (mean age 55.6 years, range 38-76 years) underwent OBR by three reconstructive breast surgeons at our institution between April 2007 and January 2013. Immediate reconstruction was performed in 21 patients, staged reconstruction (following final pathology but preceding adjuvant radiation therapy) was performed in 4 patients, and delayed reconstruction (following completion of radiation therapy) was performed in 3 patients. Volume rearrangement was performed in 23 patients, while 5 patients underwent volume replacement utilizing a lateral thoracodorsal flap. Postoperative complications were remarkable for 1 hematoma (3.6%), 5 postoperative infections (17.9%), and 1 case of nipple necrosis (3.6%). A total of 4 patients (14.3%) required reoperation. One patient who underwent immediate reconstruction (3.6%) had positive margins on final pathology and required reexcision. There was 1 incidence of local disease recurrence (3.6%), leading to completion mastectomy.

Results from our review suggest that OBR is a safe technique with a low risk of positive tumor margin or disease recurrence requiring reoperation and/or completion mastectomy.

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