Oncoplastic Breast Surgery-Common Complications and Management

Abstract

The goal of oncoplastic procedures is to resect the breast cancer with negative histological margins while preserving the contour of the breast. Volume displacement and volume replacement oncoplastic procedures have different spectrum of complications. The most significant patient factors that affect outcome are smoking and high BMI, apart from the other comorbid conditions.

Bleeding, hematoma and seroma are prevented by meticulous hemostasis and leaving a drain at the reconstructed site. Wound infection at surgical site can be prevented by administering pre-and intraoperative antibiotics routinely. Post-BCT deformity should be classified depending on the morphology and reconstructive choices. In such patients delayed partial breast reconstruction must be considered. Postoperative surveillance is an important approach to detect early recurrence, such that adequate measures can be taken. The effect of radiation therapy is different on the two categories of reconstruction methodologies—implants and flaps which are managed by local flaps and free tissue transfers.

In general local and free flaps have few common complications like donor site morbidity, fat necrosis, breast and contour asymmetry, flap loss, contracture and scars, sensory loss and other complications specific to each type of flap.

Even with the mentioned complications oncoplastic can be done safely, in most cases with low morbidity and complications resulting in excellent cosmetic results.