Sometimes it is better to just make it simple. De-escalation of oncoplastic and reconstructive procedures

Detalhes bibliográficos
Autor(a) principal: Bonci, E.-A.
Data de Publicação: 2023
Outros Autores: Anacleto, J. Correia, Cardoso, Maria-Joao
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10451/56744
Resumo: © 2023 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
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spelling Sometimes it is better to just make it simple. De-escalation of oncoplastic and reconstructive proceduresBreast cancerBreast conserving therapyOncoplastic surgeryReconstructive breast surgeryDe-escalation therapy© 2023 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)Simple breast conservation surgery (sBCS) has technically advanced onto oncoplastic breast procedures (OBP) to avoid mastectomy and improve breast cancer patients' psychosocial well-being and cosmetic outcome. Although OBP are time-consuming and expensive, we are witnessing an increase in their use, even for cases that could be managed with sBCS. The choice between keeping it simple or opting for more complex oncoplastic procedures is difficult. This review proposes a pragmatic approach in assisting this decision. Medical literature suggests that OBP and sBCS might be similar regarding local recurrence and overall survival, and patients seem to have higher satisfaction levels with the aesthetic outcome of OBP when compared to sBCS. However, the lack of comprehensive high-quality research assessing their safety, efficacy, and patient-reported outcomes hinders these supposed conclusions. Postoperative complications after OBP may delay the initiation of adjuvant RT. In addition, precise displacement of the breast volume is not effectively recorded despite surgical clips placement, making accurate dose delivery tricky for radiation oncologists, and WBRT preferable to APBI in complex OBP cases. With a critical eye on financial toxicity, patient satisfaction, and oncological outcomes, OBP must be carefully integrated into clinical practice. The thoughtful provision of informed consent is essential for decision-making between sBCS and OBP. As we look into the future, machine learning and artificial intelligence can potentially help patients and doctors avoid postoperative regrets by setting realistic aesthetic expectations.Eduard-Alexandru Bonci’s work has been supported by a UICC Technical Fellowship [grant number UICC-TF/2022-1429].ElsevierRepositório da Universidade de LisboaBonci, E.-A.Anacleto, J. CorreiaCardoso, Maria-Joao2023-03-21T12:24:18Z20232023-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10451/56744engBreast. 2023 Mar 13;69:265-2730960-977610.1016/j.breast.2023.03.0061532-3080info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-11-08T17:04:37Zoai:repositorio.ul.pt:10451/56744Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T22:07:16.329762Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Sometimes it is better to just make it simple. De-escalation of oncoplastic and reconstructive procedures
title Sometimes it is better to just make it simple. De-escalation of oncoplastic and reconstructive procedures
spellingShingle Sometimes it is better to just make it simple. De-escalation of oncoplastic and reconstructive procedures
Bonci, E.-A.
Breast cancer
Breast conserving therapy
Oncoplastic surgery
Reconstructive breast surgery
De-escalation therapy
title_short Sometimes it is better to just make it simple. De-escalation of oncoplastic and reconstructive procedures
title_full Sometimes it is better to just make it simple. De-escalation of oncoplastic and reconstructive procedures
title_fullStr Sometimes it is better to just make it simple. De-escalation of oncoplastic and reconstructive procedures
title_full_unstemmed Sometimes it is better to just make it simple. De-escalation of oncoplastic and reconstructive procedures
title_sort Sometimes it is better to just make it simple. De-escalation of oncoplastic and reconstructive procedures
author Bonci, E.-A.
author_facet Bonci, E.-A.
Anacleto, J. Correia
Cardoso, Maria-Joao
author_role author
author2 Anacleto, J. Correia
Cardoso, Maria-Joao
author2_role author
author
dc.contributor.none.fl_str_mv Repositório da Universidade de Lisboa
dc.contributor.author.fl_str_mv Bonci, E.-A.
Anacleto, J. Correia
Cardoso, Maria-Joao
dc.subject.por.fl_str_mv Breast cancer
Breast conserving therapy
Oncoplastic surgery
Reconstructive breast surgery
De-escalation therapy
topic Breast cancer
Breast conserving therapy
Oncoplastic surgery
Reconstructive breast surgery
De-escalation therapy
description © 2023 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
publishDate 2023
dc.date.none.fl_str_mv 2023-03-21T12:24:18Z
2023
2023-01-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10451/56744
url http://hdl.handle.net/10451/56744
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Breast. 2023 Mar 13;69:265-273
0960-9776
10.1016/j.breast.2023.03.006
1532-3080
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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