Conservative treatment with oncoplastic surgery : an update

During the last ten years, oncoplastic conservative breast surgery hastransitioned from being a pioneering technique to a mature one.In the beginning, there were only a few techniques available, which were strictapplications of reduction mastopexy. A synergistic confrontation betweencarcinologic and plastic surgeons has led us to modify these techniques and alsoto create some totally new ones, such as the omega or external technique, forexample. This was really an enthusiastic period, which has allowed for thecreation of a complete panel of different techniques, now available quadrant perquadrant.These techniques induce a double benefit for patients, with more conservativesurgery and better aesthetic results.Indications have also improved a lot, allowing for separation between simpleand complex cases:· Simple cases (or level 1 oncoplasty) concerns 70% of patients, and can bedefined by the absence of areolar displacement, with aesthetic incisionsand different types of direct glandular flaps to fill the glandular defect.· Complex cases (level 2 oncoplasty) concerns 30% of patients andrequires an experienced surgeon, able to perform all of the differenttechniques. Complication rates are obviously a little bit higher, butaesthetic results are usually very good.