Department of Surgery, The Paris Breast Center, L'Institut du Sein, Paris, France.
Ann Surg Oncol. 2010 May;17(5):1375-91. doi: 10.1245/s10434-009-0792-y. Epub 2010 Feb 6.
Oncoplastic surgery (OPS) has emerged as a new approach for extending breast conserving surgery (BCS) possibilities, reducing both mastectomy and re-excision rates, while avoiding breast deformities. OPS is based upon the integration of plastic surgery techniques for immediate reshaping after wide excision for breast cancer. A simple guide for choosing the appropriate OPS procedure is not available.
To develop an Atlas and guideline for oncoplastic surgery (OPS) to help in patient selection and choice of optimal surgical procedure for breast cancer patients undergoing BCS.
We stratify OPS into two levels based on excision volume and the complexity of the reshaping technique. For resections less than 20% of the breast volume (level I OPS), a step-by-step approach allows easy reshaping of the breast. For larger resections (level II OPS), a mammoplasty technique is required.
We identified three elements that can be used for patient selection and for determination of the appropriate OPS technique: excision volume, tumor location, and glandular density. For level II techniques, we defined a quadrant per quadrant Atlas that offers a different mammoplasty for each quadrant of the breast.
OPS is the "third pathway" between standard BCS and mastectomy. The OPS classification and Atlas improves patient selection and allows a uniform approach for surgeons. It proposes a specific solution for different scenarios and helps improve breast conservation outcomes.
肿瘤整形手术（Oncoplastic surgery，OPS）作为一种新的方法，已应用于扩展保乳手术（Breast Conserving Surgery，BCS）的可能性，降低了乳房切除术和再次切除的比率，同时避免了乳房畸形。OPS 是基于将整形手术技术应用于广泛切除乳腺癌后的即刻重塑。目前还没有一种简单的方法来选择合适的 OPS 手术。
为了帮助乳腺癌患者选择合适的保乳手术并选择最佳的手术方法，我们制定了一份肿瘤整形手术（Oncoplastic surgery，OPS）图谱和指南。
我们根据切除体积和重塑技术的复杂程度将 OPS 分为两个级别。对于小于乳房体积 20%的切除（I 级 OPS），采用逐步的方法可以轻松重塑乳房。对于较大的切除（II 级 OPS），需要采用乳房成形术技术。
我们确定了三个可以用于患者选择和确定适当的 OPS 技术的因素：切除体积、肿瘤位置和腺体密度。对于 II 级技术，我们定义了一个象限-象限图谱，为乳房的每个象限提供不同的乳房成形术。
OPS 是标准 BCS 和乳房切除术之间的“第三条路径”。OPS 分类和图谱提高了患者的选择，并为外科医生提供了统一的方法。它针对不同的情况提出了具体的解决方案，有助于提高保乳治疗的效果。
