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Cancers
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Oncoplastic Techniques and Mastectomy in Breast Cancer
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Oncoplastic Techniques and Mastectomy in Breast Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Clinical Research of Cancer".

Deadline for manuscript submissions: closed (20 April 2025) | Viewed by 8166

Special Issue Editor

Dr. Giovanni Papa

E-Mail Website
Guest Editor
1. Department of Life Sciences, University of Trieste, Trieste, Italy
2. Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
Interests: acellular dermal matrix; regenerative medicine; breast surgery

Special Issue Information

Dear Colleagues,

Breast cancer is the leading oncological diagnosis in women worldwide, accounting for more than 287,000 cases in 2022. Among multidisciplinary treatments, surgery maintains its leading role in terms of locoregional control, locoregional staging, and risk reduction strategies. Oncoplastic breast surgery has gained popularity across the world. There has been a paradigm shift towards the de-escalation of various aspects of breast cancer surgery without compromising the oncological outcome. The wider use of various mammoplasty techniques has helped to expand the scope of breast conservation surgery. Newer localisation techniques for clinically non-palpable cancers have significantly helped surgeons to use theatre time more efficiently with a better patient experience. Likewise, the availability of better implants and acellular dermal matrices and other meshes has been instrumental in widening the reconstructive options available to our patients. The future of breast surgery is exciting with ongoing innovations in various fields such as resection margin assessment methods and with the wider application of artificial intelligence in various aspects of breast cancer management.

The present Special Issue will provide an overview of the latest evidence in the field of breast cancer surgery focusing on BCS, oncoplastic surgery, prosthetic breast reconstruction, and reconstructive strategies. Therefore, we welcome the submission of review articles and original research papers.

Dr. Giovanni Papa
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • breast cancer
  • breast reconstruction
  • mammoplasty
  • breast implants
  • acellular dermal matrix
  • direct-to-implant reconstruction
  • two-stage breast reconstruction
  • breast-conserving surgery

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Published Papers (3 papers)

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Research

11 pages, 1420 KiB  
Article
Complication Rates After Mastectomy and Reconstruction in Breast Cancer Patients Treated with Hypofractionated Radiation Therapy Compared to Conventional Fractionation: A Single Institutional Analysis
by Tal Falick Michaeli, Feras Hatoom, Antoni Skripai, Ella Wajnryt, Tanir M. Allweis, Shani Paluch-Shimon, Yair Shachar, Aron Popovtzer, Marc Wygoda and Philip Blumenfeld
Cancers 2025, 17(1), 106; https://doi.org/10.3390/cancers17010106 - 1 Jan 2025
Viewed by 912
Abstract
Introduction: Radiation therapy plays an important role in the treatment of localized breast cancer. Hypofractionated (HF) radiation therapy has emerged as a promising alternative to conventional fractionation (CF) schedules, offering comparable efficacy with reduced treatment duration and costs. However, concerns remain regarding its [...] Read more.
Introduction: Radiation therapy plays an important role in the treatment of localized breast cancer. Hypofractionated (HF) radiation therapy has emerged as a promising alternative to conventional fractionation (CF) schedules, offering comparable efficacy with reduced treatment duration and costs. However, concerns remain regarding its safety and rate of toxicity, particularly in patients undergoing mastectomy with breast reconstruction. This study aimed to assess the implant-related complications in breast cancer patients receiving HF post-mastectomy radiation therapy (PMRT) and reconstruction compared to CF PMRT. Methods: A retrospective study was conducted on 59 breast cancer patients who underwent mastectomy and breast reconstruction between 2013 and 2021 and received adjuvant PMRT. Patient demographics, treatment characteristics, and implant-related complications were analyzed. Statistical tests including chi-square, Fischer’s exact test, and multivariable Cox regression were employed for analysis. Results: Of the 59 patients, 29 received HF PMRT and 30 received CF PMRT. At a median follow-up of 23.4 months, there was no significant difference in major implant-related complications between the two groups (24.1% in HF vs. 33.3% in CF, p = 0.436). Most complications in the HF group occurred within the first two years post-radiation. Age over 40 was identified as a significant predictor for higher implant-related complications (p = 0.029). Conclusions: Our findings indicate that HF PMRT and reconstruction does not increase the risk of major implant-related complications compared to CF PMRT. These results align with the existing literature, supporting the safety of HF radiation in breast cancer patients who underwent mastectomy with reconstruction. Full article
(This article belongs to the Special Issue Oncoplastic Techniques and Mastectomy in Breast Cancer)
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11 pages, 225 KiB  
Article
A Multi-Center Retrospective Observational Analysis of Three-Year Experience of Our Protocol for Prevention and Monitoring of Surgical Site Infections in Implant-Based Breast Reconstruction
by Stefano Bottosso, Giulia Benedetta Sidoti, Ludovica Vita, Alessandro Scian, Luigi Bonat Guarini, Nadia Renzi, Vittorio Ramella and Giovanni Papa
Cancers 2024, 16(13), 2439; https://doi.org/10.3390/cancers16132439 - 2 Jul 2024
Viewed by 1307
Abstract
Background: With the rise in the mastectomy rate, the number of patients who choose to undergo postmastectomy reconstruction has been increasing, and implant-based procedures are the most performed methods for postmastectomy breast reconstruction. Among the possible complications, the most feared is the loss [...] Read more.
Background: With the rise in the mastectomy rate, the number of patients who choose to undergo postmastectomy reconstruction has been increasing, and implant-based procedures are the most performed methods for postmastectomy breast reconstruction. Among the possible complications, the most feared is the loss of reconstruction. It can be related to several reasons, but one of the most common is infection of the implant, which can lead to prolonged antibiotic treatment, undesired additional surgical procedures, increased incidence of capsular contracture, and unsatisfactory aesthetics results, with a huge psychological impact on patients. Aims: The primary intent of this study is to analyze the status of infection rates at our institution and evaluate the effectiveness of our prevention protocol since its introduction. Secondly, we compared data of the surgical site infections (SSIs) after implant-based breast reconstruction at Trieste Hospital, where the protocol has been employed since 2020, and in another center, where plastic surgeons of our team are involved, with different prevention procedures. Methods and Results: We enrolled 396 female patients, who underwent implant-based breast reconstruction, using definitive mammary implants or breast tissue expanders, with or without ADM (acellular dermal matrix), both for breast cancer and risk-reducing surgery in BRCA1/2 patients. Patients treated at the Hospital of Trieste, with the use of the prevention protocol, were considered the experimental group (group 1), while patients treated in Gorizia by the same breast team with standardized best-practice rules, but without the use of the prevention protocol, were considered the control group (group 2). Infected patients were 5 in the first group (1.7%) and 8 in the second one (7.9%), with a global infection rate of 3.2%. Conclusion: After the introduction of our prevention protocol, we faced a lower incidence of infection after breast surgery with implants or tissue expanders. Full article
(This article belongs to the Special Issue Oncoplastic Techniques and Mastectomy in Breast Cancer)
13 pages, 2142 KiB  
Article
Surgical De-Escalation for Re-Excision in Patients with a Margin Less Than 2 mm and a Diagnosis of DCIS
by Gianluca Vanni, Marco Pellicciaro, Nicola Di Lorenzo, Rosaria Barbarino, Marco Materazzo, Federico Tacconi, Andrea Squeri, Rolando Maria D’Angelillo, Massimiliano Berretta and Oreste Claudio Buonomo
Cancers 2024, 16(4), 743; https://doi.org/10.3390/cancers16040743 - 10 Feb 2024
Cited by 3 | Viewed by 5334
Abstract
The current surgical guidelines recommend an optimal margin width of 2 mm for the management of patients diagnosed with ductal carcinoma in situ (DCIS). However, there are still many controversies regarding re-excision when the optimal margin criteria are not met in the first [...] Read more.
The current surgical guidelines recommend an optimal margin width of 2 mm for the management of patients diagnosed with ductal carcinoma in situ (DCIS). However, there are still many controversies regarding re-excision when the optimal margin criteria are not met in the first resection. The purpose of this study is to understand the importance of surgical margin width, re-excision, and treatments to avoid additional surgery on locoregional recurrence (LRR). The study is retrospective and analyzed surgical margins, adjuvant treatments, re-excision, and LRR in patients with DCIS who underwent breast-conserving surgery (BCS). A total of 197 patients were enrolled. Re-operation for a close margin rate was 13.5%, and the 3-year recurrence was 7.6%. No difference in the LRR was reported among the patients subjected to BCS regardless of the margin width (p = 0.295). The recurrence rate according to margin status was not significant (p = 0.484). Approximately 36.9% (n: 79) patients had resection margins < 2 mm. A sub-analysis of patients with margins < 2 mm showed no difference in the recurrence between the patients treated with a second surgery and those treated with radiation (p = 0.091). The recurrence rate according to margin status in patients with margins < 2 mm was not significant (p = 0.161). The margin was not a predictive factor of LRR p = 0.999. Surgical re-excision should be avoided in patients with a focally positive margin and no evidence of the disease at post-surgical imaging. Full article
(This article belongs to the Special Issue Oncoplastic Techniques and Mastectomy in Breast Cancer)
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