Oncoplastic and reconstructive breast surgery. Single institution experience

Summary. Breast cancer requires an integrated multidisciplinary approach in the framework of a dedicated Breast Unit. It allows to implement and develop effectively oncoplastic and reconstructive surgery to improve oncological and aesthetic results. The surgical approaches and experience the Centre of Modern Mammology (CMM) of LISOD hospital are presented. 703 operations for 512 patients was performed from 2007 to 02.2015 in CMM. 295 oncoplastic breastconserving surgeries were performed in 288 patients. 249 (86.5%) patients were followed-up. Average follow-up was 39.7 (5–93) months. Local recurrences occurred in 6 (2.4%), metastases were found out in 24 (9.6%) and 15 (6.0%) of them died. 94 immediate reconstructions after mastectomy were performed in 78 patients. Single-stage reconstructions with a permanent implant were made in 32 (34.0%) patients, two-staged (expander/implant) — in 29 (30.9%). Reconstruction with latissimus dorsi (LD) flap was performed in 7 (7.4%), LD + implant — in 6 (6.3%), pedicled TRAM-flap — in 4 (4.2%) patients. Skin-sparing mastectomy were made in 35 (37.3%), nipple-sparing — in 24 (25.5%) patients. 67 (86.0%) patients were followed-up. Average follow-up was 28 (6–70) months. Local recurrence was found in 1 (1.5%), metastasis occurred in 9 (13.4%) and 2 (3.0%) of them died. Our results show that Breast Unit organized ­according to EUSOMA criteria is an optimal model of breast cancer care. It allows treating the patients according to international standards.