Article: Oncoplastic breast-conserving surgery with BioZorb® technology
|What is oncoplastic surgery?||What does this mean for me?|
|What is BioZorb?||Limitations|
|Questions for your doctor||Resources|
Oncoplastic surgery refers to the procedure where a breast is reconstructed after breast-conservation surgery (). A removes the tumor and surrounding tissue. With oncoplastic surgery, the remaining tissue is then rearranged to fill the space or divots left on the breast. The opposite breast may also be modified for symmetry.
Why is oncoplastic surgery important?
According to the Radiological Society of North America, 75 to 80 percent of patients can be treated with breast-conservation therapy () rather than mastectomy, with similar recurrence results compared to mastectomy. While allows women to forego mastectomy, removing tissue often distorts the size, shape and symmetry of the remaining breast. Radiation treatment compounds the problem. Introduced in the 1980s, radiation therapy revolutionized breast cancer treatment. It kills remaining cancer cells and reduces the risk of recurrence, but it also extends into healthy tissue, shrinking blood vessels and elasticity and further compromising the natural look and feel of the breast.
BioZorb minimizes radiation to healthy tissue, which reduces cosmetic damage in the remaining breast tissue. After the tumor is removed, a walnut-sized BioZorb coil is implanted at the tumor site. Small titanium clips along the framework precisely mark the area to be radiated. Because the exact field of radiation is better defined, more healthy tissue remains unaffected. The article states that the device supports the remaining tissue as it heals, limiting scarring and reducing the likelihood of developing “divots” that many patients experience when tissue is removed. Over a year or more, the BioZorb framework is reabsorbed into the body, while the clips remain as a permanent marker to aid future imaging.
Some women who are diagnosed with breast cancer aren’t interested in other procedures beyond mastectomy—they just want their breast and the cancer gone. But breast-conserving therapy followed by radiation treatment and sometimes chemotherapy has proven to be an effective treatment for breast cancer.
Many breast cancer patients, however, are unfamiliar with oncoplastic surgery or the BioZorb implant, or they may not have access to a surgeon or facility where oncoplasty is performed. In The Columbian interview, Dr. Peled stated, “Nationally, less than 10 percent of women undergoing a have oncoplastic reconstruction.” By sharing her own experience, she hopes to spread the word about oncoplastic surgery and BioZorb as a way to help improve cosmetic outcomes for many patients after a .
It is important to make a clear distinction between oncoplastic surgery and a device (BioZorb). Oncoplastic does not require the use of BioZorb. In addition, not all breast surgeons perform oncoplastic lumpectomies. This surgical procedure depends on the surgeon. If you are considering , consult with an oncoplastic surgeon and discuss whether the use of a BioZorb implant is a good option for you.
The article with Dr. Peled included no discussion regarding prior research on BioZorb. Approved by the in 2012, the device was shown to improve outcomes and follow-up care in two separate studies that were presented at the 2017 Annual Meeting of the American Society of Breast Surgeons.
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“Breast cancer surgeon diagnosed with breast cancer advocates oncoplastic surgery.” January 22, 2018, The Columbian.
Leonard KL, et al. “Placement of the BioZorb® marker is associated with smaller irradiated tumor bed in patients receiving breast conserving therapy.” Poster presentation at the 18th Annual Meeting of the American Society of Breast Surgeons, April 26-30, 2017; Las Vegas, NV.
Cross MJ, Jones S, Smith A, et al. “Impact of a 3D bioabsorbable implant on the rate of breast conserving surgery: review of 1,115 breast cancer patients in the private practice setting.” Poster presentation at the 18th Annual Meeting of the American Society of Breast Surgeons, April 26-30, 2017; Las Vegas, NV.
This article is relevant for:
Women undergoing lumpectomy for breast cancer
This article is also relevant for:
people with breast cancer
Be part of XRAY:
- Is a or mastectomy more effective for me?
- Do you provide oncoplastic ? If not, how can I find a surgeon who does?
- Will I need radiation therapy after my ?
- Can I benefit from a BioZorb implant?
The following are studies related to breast reconstruction or no reconstruction after mastectomy.
- NCT04533373: Sensory Restoration After Flap Neurotization. The goal of this study is to look at how well a nerve graft works for improving sensation to the reconstructed breast after mastectomy in people undergoing flap reconstruction.
- NCT04491591: Implementing BREASTChoice Into Practice. Breast reconstruction after mastectomy is a highly personal decision. A clinical decision support tool, BREASTChoice, with personalized risk information and patient preferences, was created to be used to address these issues. This study will evaluate whether BREASTChoice assists reconstruction decisions.
- NCT04293146: Pre- Versus Sub-pectoral Implant-based Breast Reconstruction After Skin-sparing Mastectomy or Nipple-sparing Mastectomy OPBC-02PREPEC. This study will compare the effect of under-the-muscle versus over-the-muscle reconstruction on quality-of-life outcomes.
NCT05020574: Microbiome and Association With Implant Infections. The study is looking at whether people with high amounts of certain types of bacteria are more likely to develop tissue expander-related infections than those with lower amounts of bacteria.
The following resources can help you find a plastic surgeon who specializes in breast reconstruction:
Finding a plastic surgeon
- The American Society of Plastic Surgeons has a searchable Plastic Surgeon Referral Service database.
Other ways to find experts
- Register for the FORCE Message Boards and post on the Find a Specialist board to connect with other people who share your situation.
- The website for the Breast Reconstruction Guidebook provides information on Choosing the Right Surgeon.