Breast Reduction Surgery in Adolescents.

Macromastia-overgrowth of the female breast-is distressing and disabling, often starting in middle school and continuing into adulthood. Breast reduction is an effective treatment of symptoms of macromastia in adults, and its application in adolescents has been increasing. Special considerations within the adolescent population include interruption of age-appropriate activities, development of healthy body image/esteem, the connection to obesity, potential for postoperative recurrence/continued growth, the effect of surgery on future lactation and breast-feeding, and the adolescent's ability to participate in surgical decision-making (assent). This review highlights these issues and reviews breast reduction surgery outcomes and complications as they apply to the female adolescent. After reading this article, the reader should be able to identify adolescents who may be candidates for breast reduction surgery and have the information needed to counsel patients before their referral to a surgeon. [Pediatr Ann. 2023;52(1):e31-e35.].

An Oncoplastic Surgery Primer: Common Indications, Techniques, and Complications in Level 1 and 2 Volume Displacement Oncoplastic Surgery.

Oncoplastic surgery is a form of breast-conservation surgery that involves volume displacement and replacement techniques for optimal aesthetic results after oncologic resection with partial mastectomy. With growing emphasis on breast conservation, oncoplastic surgery is becoming a critical component in the approach to breast cancer in appropriately selected patients. Thus, it is paramount that surgeons are informed about oncoplastic surgery and its use in breast cancer treatment. This primer aims to provide key information regarding oncoplastic surgery. To accomplish this, we used supportive evidence from the literature, combined with clinical experience. The primer uses the American Society of Breast Surgeon's consensus definition and classification system for oncoplastic surgery, focusing on level 1 and 2 volume displacement techniques. We outline procedures within these categories, review common indications, and provide a guide to approaching tumors based on their quadrant position. The paper also describes complications specific to these procedures, as well as their management. Understanding these concepts will allow surgeons to assist patients in making informed decisions using these breast-conservation techniques.

A Consensus Definition and Classification System of Oncoplastic Surgery Developed by the American Society of Breast Surgeons.

BACKGROUND: Several definitions of oncoplastic surgery have been reported in the literature. In an effort to facilitate communication regarding oncoplastic surgery to patients, trainees, and among colleagues, the American Society of Breast Surgeons (ASBrS) aimed to create a consensus definition and classification system for oncoplastic surgery. METHODS: We performed a comprehensive literature search for oncoplastic surgery definitions using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Following this, a consensus definition and classification system was created by the ASBrS. RESULTS: Overall, 30 articles defining oncoplastic surgery were identified, with several articles contradicting each other. The ASBrS definition for oncoplastic surgery defines this set of breast-conserving operations using volume displacement and volume replacement principles as: "Breast conservation surgery incorporating an oncologic partial mastectomy with ipsilateral defect repair using volume displacement or volume replacement techniques with contralateral symmetry surgery as appropriate". Volume displacement is defined as closing the lumpectomy defect and redistributing the resection volume over the preserved breast, and is divided into two levels: level 1 (< 20%) and level 2 (20-50%). Volume replacement includes those situations when volume is added using flaps or implants to correct the partial mastectomy defect. CONCLUSION: The ASBrS oncoplastic surgery definition and classification system provides language to facilitate discussion and teaching of oncoplastic surgery among breast surgeons, trainees, and patients.