TY - JOUR
T1 - Modified oncoplastic lift, lymphatic excision, and reconstruction
T2 - Introduction of a novel technique in oncoplastic breast surgery with simple surgical principles
AU - De la Cruz Ku, Gabriel
AU - Desai, Anshumi
AU - Narvaez-Rojas, Alexis R.
AU - Zheng, Caiwei
AU - Collier, Amber
AU - Weber, Lee
AU - Kassira, Wrood
AU - Avisar, Eli
AU - Möller, Mecker G.
N1 - Publisher Copyright:
© 2023 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland
PY - 2024/12
Y1 - 2024/12
N2 - Introduction: Oncoplastic surgery is an important component of the management of breast cancer. As prognosis has improved, the need for proficient techniques to achieve disease eradication while maintaining cosmesis for naturally appearing breasts has gained importance. This study describes an easy-to-learn modified oncoplastic technique for patients undergoing breast-conserving treatment. Description of the technique: Tumor resection is performed through different peri-areolar, inframammary, or radial incisions. To reduce the size of the surgical defect created after tissue resection, an internal purse-string is performed parallel to the chest wall or base of the wound with subsequent staggering in three or more layers as needed, while maintaining the parallel orientation of the needle. This is followed by the creation and overlapping of internal breast tissue flaps that are rearranged to decrease the dead space with the aim of improving cosmesis. The redundant skin is removed for the skin envelope to maintain shape. The wound is closed in layers. We also describe steps in performing sentinel lymph node and tumor extraction through the same periareolar, inframammary, or radial incisions for tumors located in outer quadrants. Following closure, contour and projection of the breast were maintained without indentation or loss of projection, with a symmetrical appearance to the contralateral side. Conclusion: This modified oncoplastic lift, lymphatic excision, and reconstruction (MOLLER) technique can be easily learned and used by surgeons who treat cancer patients and have limited oncoplastic training. It uses basic known surgical principles to decrease the size of the defect created while minimizing the need for larger incisions/pedicles.
AB - Introduction: Oncoplastic surgery is an important component of the management of breast cancer. As prognosis has improved, the need for proficient techniques to achieve disease eradication while maintaining cosmesis for naturally appearing breasts has gained importance. This study describes an easy-to-learn modified oncoplastic technique for patients undergoing breast-conserving treatment. Description of the technique: Tumor resection is performed through different peri-areolar, inframammary, or radial incisions. To reduce the size of the surgical defect created after tissue resection, an internal purse-string is performed parallel to the chest wall or base of the wound with subsequent staggering in three or more layers as needed, while maintaining the parallel orientation of the needle. This is followed by the creation and overlapping of internal breast tissue flaps that are rearranged to decrease the dead space with the aim of improving cosmesis. The redundant skin is removed for the skin envelope to maintain shape. The wound is closed in layers. We also describe steps in performing sentinel lymph node and tumor extraction through the same periareolar, inframammary, or radial incisions for tumors located in outer quadrants. Following closure, contour and projection of the breast were maintained without indentation or loss of projection, with a symmetrical appearance to the contralateral side. Conclusion: This modified oncoplastic lift, lymphatic excision, and reconstruction (MOLLER) technique can be easily learned and used by surgeons who treat cancer patients and have limited oncoplastic training. It uses basic known surgical principles to decrease the size of the defect created while minimizing the need for larger incisions/pedicles.
KW - Breast cancer surgery
KW - Lumpectomy
KW - Oncoplastic surgery
KW - Partial mastectomy
UR - http://www.scopus.com/inward/record.url?scp=85181255148&partnerID=8YFLogxK
U2 - 10.1016/j.surge.2023.12.001
DO - 10.1016/j.surge.2023.12.001
M3 - Artículo de revisión
AN - SCOPUS:85181255148
SN - 1479-666X
VL - 22
SP - e193-e201
JO - Surgeon
JF - Surgeon
IS - 6
ER -