Surgery of cosmetic sequelae after breast-conserving therapy.

Although a considerable number of patients have an unfair cosmetic result after breast-conserving therapy, which correlates with poor psychosocial functioning, surprisingly, really only very few patients undergo surgical correction. The purpose of this article was to report our experience in the surgical treatment of such patients and analyze a special subgroup which required bilateral reduction mammaplasty because of associated symptomatic macromastia and their desire to reduce their breast size. From July 2000 to November 2008, some 23 patients consulted for unsatisfactory cosmetic outcome after breast-conserving therapy, fourteen of them accepting the surgical treatment proposed and these were operated upon.

Reduction mammaplasty: an advantageous option for breast conserving surgery in large-breasted patients.

Oncoplastic breast conserving surgery is a good approach for large-breasted women with breast cancer, as it increases the rate of breast conserving surgery, improves cosmetic results and prevents both cosmetic sequelae and the symptoms associated with macromastia. We reviewed ten publications in which 276 patients had been treated with bilateral reduction mammaplasty. All showed the same conclusion: women with breast cancer and macromastia candidates for breast conserving surgery could obtain clear oncological and cosmetic advantages and an improvement in quality of life if they were treated using bilateral reduction onco-therapeutic mammaplasty.

Oncoplastic techniques extend breast-conserving surgery to patients with neoadjuvant chemotherapy response unfit for conventional techniques.

Background: Oncoplastic surgery is extending the role of breast-conserving surgery in an increasing number of patients who are unsuitable for conventional breast-conserving techniques. The aim of this retrospective study was to analyze the surgical approach, oncoplastic surgery guided by bracketing, used in the treatment of patients who required a wide breast tissue excision after neoadjuvant chemotherapy. The parameters evaluated were as follows: margin status, rate of re-excision for positive margin, early ipsilateral recurrence, and cosmetic outcomes.

Oncoplastic breast-conserving surgery: analysis of quadrantectomy and immediate reconstruction with latissimus dorsi flap.

Background: Oncoplastic breast-conserving surgery satisfies oncologic principles and improves cosmetic outcomes, even when an important breast volume excision is required.

Methods: We reviewed 28 patients suffering from breast cancer treated with quadrantectomy and immediate myocutaneous latissimus dorsi flap reconstruction. We evaluated the status of the surgical margins, early complications, and cosmetic outcome.

Surgical treatment of persistent hyperinsulinemic hypoglycemia (PHH) (insulinoma and nesidioblastosis).

Background: The persistent hyperinsulinemic hypoglycemia is characterized by clinical symptoms that occur when the blood glucose levels drop below the normal range. Two pathological situations cause this clinical problem: The presence of a tumor of the pancreas secreting excessive amounts of insulin, known as insulinoma, and congenital beta-cell hyperplasia in the pancreas in children and noninsulinoma pancreatogenic hypoglycemia syndrome in adults.

Patients And Methods: Clinical characteristic and surgical outcome of a group of 20 patients operated on for this hypoglycemic syndrome; 18 for insulinoma and two for nesidioblastosis in children was studied.

Needle-wire-guided breast tumor excision.

Complete resection of large-size tumors can be easily approachable developing needle-guide tumour excision, in the context of Oncoplastic Conservative Breast Surgery. Needles are used as markers showing optimal excision margins, especially at conflicting points.