By

Dr. KARIM FAHMY

DR.RANA YOUSSRY

Supervised by

Prof. Dr. FATEEN ANOUS

Definition of term Definition of term

‘‘oncoplastic’’:‘‘oncoplastic’’:

Oncoplastic surgery defines the appropriate

adequate surgery to extirpate a cancer in the breast

combined with partial or total reconstruction

Indication for oncoplastic Indication for oncoplastic techniquestechniques

10% volume resection. Central location. Lower pole location. Medial pole location. Ptotic small breasts. Multifocality UOQ lesions.? the gravity of the breast

parenchyma may stretch the skin over the defect and may improve cosmesis without using a local oncoplastic technique

Contraindications for oncoplastic Contraindications for oncoplastic techniquestechniques

Inflammatory carcinoma.

Multicentric carcinoma.

Progressive disease after neoadjuvant therapy.

Without adjuvant radiotherapy.

Volume displacement

• Level 1

• Intra-mammarian flap

Volume replacement

TRAM

MINI LD FLAP

Prosthetic implant

Types

Level 2

•Inferior pedicle techniques

• Superior pedicle techniques

• Vertical scar techniques

•Round block techniques

• Grisotti flaps

•Doughnut mastopexy

•L mamoplasty

•S shaped mamoplasty

•Batwing mamoplasty

Advantage of oncoplastic Advantage of oncoplastic techniques techniques

*Increase Of Resection Volume

*Better Cosmetic Results

Disadvantages of oncoplastic Disadvantages of oncoplastic techniquestechniques

Prolongation of operative time.

Increase local morbidities e.g.. Skin necrosis

and wound dehiscence

Different oncoplastic Different oncoplastic techniques for techniques for

Reconstruction of Partial Reconstruction of Partial Mastectomy DefectsMastectomy Defects

Superior Pedicle Reduction Superior Pedicle Reduction MammaplastyMammaplasty

Superior pedicle reduction Superior pedicle reduction mammaplastymammaplasty

Superior pedicle reduction Superior pedicle reduction mammaplastymammaplasty

Superior Pedicle Reduction Superior Pedicle Reduction MammaplastyMammaplasty

Superior Pedicle Reduction Superior Pedicle Reduction MammaplastyMammaplasty

Superior Pedicle Reduction Superior Pedicle Reduction MammaplastyMammaplasty

Postoperative View 3 Years

After Partial Mastectomy

And Superior-based Pedicle

Reduction Mammaplasty.

56-year-old Woman With A

21 Mm Breast Cancer In

The Lower Quadrant Of The

Left Breast.

Inferior Pedicle Inferior Pedicle Mammaplasty for Mammaplasty for

Reconstruction of Partial Reconstruction of Partial Mastectomy DefectsMastectomy Defects

Medial or Lateral Pedicle Medial or Lateral Pedicle Vertical Breast Vertical Breast

Reduction(Hall-Findlay or Reduction(Hall-Findlay or Snowman Technique)Snowman Technique)

.

S-Shaped Oblique Reduction S-Shaped Oblique Reduction Mammaplasty for Mammaplasty for Reconstruction Reconstruction

of Partial Mastectomy Defectsof Partial Mastectomy Defects

preoperative view of a 56-year-old woman operated with an S-shaped oblique reduction.

postoperative result 3 years after surgery and radiation.

Volume replacementVolume replacement

TRAM

TRAM