EXTREME ONCOPLASTY

Extreme oncoplasty is defined as a breast conserving surgery, using oncoplastic techniques, in patients who, in most physicians’ opinions, requires a mastectomy. These are generally large, greater than 5 cm multifocal or multicentric tumors. They may be locally advanced. Many will have positive lymph nodes. Most of these patients will require radiation therapy, even if they are treated with mastectomy. The reason to save a breast like this is that in many cases, breast conservation may be a better alter-native. It is classified into volume displacement and volume replacement techniques. These include therapeutic mammoplasty and chest wall perforator flaps. The rate of complications is similar to the standard oncoplastic surgery and the oncologic outcomes are shown to be similar to outcomes from breast conserving surgery and mastectomy. Extreme oncoplasty is a suitable option for patients with advanced breast cancer that would have been otherwise considered for mastectomy.