grekovВестник хирургии имени И.И. ГрековаGrekov's Bulletin of Surgery0042-46252686-7370Federal State Budgetary Educational Institution of Higher Education «Academician I.P. Pavlov First St. Petersburg State Medical University» of the Ministry of Healthcare of the Russion Federation, FSBEI HE I.P.Pavlov SPbSMU MOH Russia10.24884/0042-4625-2019-178-5-36-46grekov-971Research ArticleПЛАСТИЧЕСКАЯ И РЕКОНСТРУКТИВНАЯ ХИРУРГИЯPLASTIC AND RECONSTRUCTIVE SURGERYАКТУАЛЬНЫЕ ВОПРОСЫ ОНКОПЛАСТИЧЕСКОЙ ОРГАНОСОХРАНЯЮЩЕЙ ХИРУРГИИ РАКА МОЛОЧНОЙ ЖЕЛЕЗЫACTUAL ISSUES OF ONCOPLASTIC ORGAN-PRESERVING SURGERY OF BREAST CANCERРябчиковД. А.RyabchicovD. A.

Рябчиков Денис Анатольевич - канд. мед. наук, ведущий научный сотрудник хирургического отделения опухолей молочных желез

Denis A. Ryabchicov

dr.denisr@mail.ruВоротниковИ. К.VorotnikovI. K.

Воротников Игорь Константинович - д-р мед. наук, профессор, зав. хирургическим отделением опухолей молочных желез

Igor K. Vorotnikov

i.vorotnicov@mail.ruДудинаИ. А.DudinaI. A.

Дудина Ирина Александровна - студентка VI курса факультета международной школы «Медицина Будущего»

Irina A. Dudina

miss.rowe@yandex.ruКазаковА. М.KazakovA. M.

Казаков Алексей Михайлович - клинический ординатор;

Aleksey M. Kazakov

Kazakovich873@gmail.comДенчикД. А.DenchikD. A.

Денчик Данила Александрович - канд. мед. наук, научный сотрудник хирургического отделения опухолей молочных желез

Danila A. Denchik

dda.84@mail.ruФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр онкологии имени Н. Н. Блохина» Министерства здравоохранения Российской ФедерацииN. N. Blokhin Russian Cancer Research CenterФедеральное государственное автономное образовательное учреждение высшего образования «Первый Московский государственный медицинский университет имени И. М. Сеченова» Министерства здравоохранения Российской Федерации (Сеченовский университет)РоссияI. M. Sechenov First Moscow State Medical University (Sechenov University)Russian Federation20193107201917853646Copyright © Рябчиков Д.А., Воротников И.К., Дудина И.А., Казаков А.М., Денчик Д.А., 20192019Рябчиков Д.А., Воротников И.К., Дудина И.А., Казаков А.М., Денчик Д.А.Ryabchicov D.A., Vorotnikov I.K., Dudina I.A., Kazakov A.M., Denchik D.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.vestnik-grekova.ru/jour/article/view/971

Хирургическое лечение рака молочной железы (РМЖ) за последние полвека претерпело существенные изменения. Онкопластические операции – относительно новый вариант органосохраняющего хирургического лечения РМЖ, идея которого заключается в объединении принципов онкологической и пластической хирургии с целью получения онкологически безопасных и эстетически приемлемых результатов. Несмотря на широкое внедрение данных операций, высококачественных исследований о его преимуществах в сравнении с другими методиками недостаточно. В данном обзоре литературы будут рассмотрены актуальные вопросы онкопластической хирургии РМЖ, такие как показания к операции, классификации онкопластических методик, определение положительных краев резекции, оценка рецидивирования и выживаемости, послеоперационных осложнений, эстетического результата.

Авторы заявили об отсутствии конфликта интересов.

Авторы подтверждают, что соблюдены права людей, принимавших участие в исследовании, включая получение информированного согласия в тех случаях, когда оно необходимо, и правила обращения с животными в случаях их использования в работе (Заключение ЛЭК при Северном государственном медицинском университете от 08.04.2015 г., протокол № 02/4–15). Подробная информация содержится в Правилах для авторов.

Surgical treatment of breast cancer (BC) has undergone significant changes over the past half century. Oncoplastic operations are a relatively new variant of organ-preserving surgical treatment of breast cancer. Its idea is to combine the principles of oncology and plastic surgery in order to obtain oncological safe and cosmetic acceptable results. Despite the widespread implementation of these operations, high-quality studies on the benefits of oncoplastic operations in comparison with other methods are not enough. Actual issues of breast cancer oncoplastic surgery was considered in this literature review, such as indications for surgery, classification of oncoplastic techniques, determination of positive resection margins, evaluation of recurrence and survival, postoperative complications, cosmetic result.

The authors declare no conflict of interest.

The authors confirm that they respect the rights of the people participated in the study, including obtaining informed consent when it is necessary, and the rules of treatment of animals when they are used in the study (Conclusion of the local Ethics Committee at Northern State Medical University of 08.04.2015, Protocol No. 02/4-15). Author Guidelines contains the detailed information.

рак молочной железыонкопластические операцииобзоросложнениябезопасностьbreast canceroncoplastic surgeryreviewcomplicationsoncological safetyReferencesGLOBOCAN. International Agency for Research on Cancer – 2012. 2012.GLOBOCAN. International Agency for Research on Cancer – 2012. 2012.Survival Comparisons for Breast Conserving Surgery and Mastectomy Revisited : Community Experience and the Role of Radiation Therapy / A. A. Onitilo, J. M. Engel, R. V. Stankowski, S. A. Doi // Clin. Med. Res. 2015. Vol. 13, № 2. P. 65–73. Doi: 10.3121/cmr.2014.1245.Onitilo A. A., Engel J. M., Stankowski R. V., Doi S. A. Survival Comparisons for Breast Conserving Surgery and Mastectomy Revisited: Community Experience and the Role of Radiation Therapy. Clin Med Res. 2015;13(2):65–73. Doi: 10.3121/cmr.2014.1245.Clarke M., Collins R., Darby S. et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival : an overview of the randomised trials // Lancet. 2005. № 366. P. 2087–2106. Doi: 10.1016/S0140-6736(05)67887-7.Clarke M., Collins R., Darby S. et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005;(366):2087–2106. Doi: 10.1016/S0140-6736(05)67887-7.Franceschini G., Sanchez A. M., Leone A. D. et al. New trends in breast cancer surgery : a therapeutic approach increasingly efficacy and respectful of the patient // G. Chir. 2015. Vol. 36, № 4. P. 145–152. Doi: 10.11138/gchir/2015.36.4.145.Franceschini G., Sanchez A. M., Leone A. D. et al. New trends in breast cancer surgery: a therapeutic approach increasingly efficacy and respectful of the patient. G Chir. 2015;36(4):145–152. Doi: 10.11138/ gchir/2015.36.4.145.Munhoz A. M., Montag E., Gemperli R. Oncoplastic breast surgery : indications, techniques and perspectives // Gland. Surg. 2013. Vol. 2, № 3. Р. 143–157. Doi: 10.3978/j.issn.2227-684X.2013.08.02.Munhoz A. M., Montag E., Gemperli R. Oncoplastic breast surgery: indications, techniques and perspectives. Gland Surg. 2013;2(3):143–157. Doi: 10.3978/j.issn.2227-684X.2013.08.02.Carter S. A., Lyons G. R., Kuerer H. M. et al. Operative and oncologic outcomes in 9861 patients with operable breast cancer : single-institution analysis of breast conservation with oncoplastic reconstruction // Ann. Surg. Oncol. 2016. Vol. 23, № 10. Р. 3190–3198. Doi: 10.1245/s10434- 016-5407-9.Carter S. A., Lyons G. R., Kuerer H. M. et al. Operative and oncologic outcomes in 9861 patients with operable breast cancer: single-institution analysis of breast conservation with oncoplastic reconstruction.Ann Surg Oncol. 2016;23(10):3190–3198. Doi: 10.1245/s10434-016-5407-9.Clough K. B., Kaufman G. J., Nos C. et al. Improving breast cancer surgery : a classification and quadrant per quadrant atlas for oncoplastic surgery // Ann. Surg. Oncol. 2010. Vol. 17, № 5. Р. 1375–1391. Doi: 10.1245/s10434-009-0792-y.Clough K. B., Kaufman G. J., Nos C. et al. Improving breast cancer surgery: a classification and quadrant per quadrant atlas for oncoplastic surgery.Ann Surg Oncol. 2010;17(5):1375–1391. Doi: 10.1245/s10434- 009-0792-y.Piper M., Peled A. W., Sbitany H. Oncoplastic breast surgery : current strategies // Gland .Surg. 2015. Vol. 4, № 2. Р. 154–163. Doi: 10.3978/j. issn.2227-684X.2015.03.01.Piper M., Peled A. W., Sbitany H. Oncoplastic breast surgery: current strategies. Gland Surg. 2015;4(2):154–163. Doi: 10.3978/j.issn.2227- 684X.2015.03.01.Современные методы лечения рака молочной железы у пожилых / Д. А. Рябчиков, Н. К. Чепелова, И. К. Воротников, Д. А. Денчик // Рос. биотерапевт. журн. 2017. Vol. 16, № 3. Р. 24–31. Doi: 10.17650/1726- 9784-2017-16-3-24-31.Ryabchikov D. A., Chepelova N. K., Vorotnikov I. K., Denchik D. A. Sovremennye metody lecheniya raka molochnoi zhelezy u pozhilykh. Rossiiskii bioterapevticheskii zhurnal. 2017;16(3):24–31. Doi: 10.17650/1726-9784-2017-16-3-24-31. (In Russ.).De La Cruz L., Blankenship S. A., Chatterjee A. et al. Outcomes after oncoplastic breast-conserving surgery in breast cancer patients : a systematic literature review // Ann. Surg. Oncol. 2016. Vol. 23, № 10. Р. 3247–3258. Doi: 10.1245/s10434-016-5313-1.De La Cruz L., Blankenship S. A., Chatterjee A. et al. Outcomes after oncoplastic breast-conserving surgery in breast cancer patients: a systematic literature review.Ann Surg Oncol. 2016;23(10):3247–3258. Doi: 10.1245/s10434-016-5313-1.Peled A. W., Sbitany H., Foster R. D. et al. Oncoplastic mammoplasty as a strategy for reducing reconstructive complications associated with postmastectomy radiation therapy // Breast J. 2014. Vol. 20. Р. 302– 307. Doi: 10.1111/tbj.12257.Peled A. W., Sbitany H., Foster R. D. et al. Oncoplastic mammoplasty as a strategy for reducing reconstructive complications associated with postmastectomy radiation therapy. Breast J. 2014;20:302–307. Doi: 10.1111/tbj.12257.Kronowitz S. J., Feledy J. A., Hunt K. K. et al. Determining the optimal approach to breast reconstruction after partial mastectomy // Plast. Reconstr. Surg. 2006. Vol. 117. Р. 1–11.Kronowitz S. J., Feledy J. A., Hunt K. K. et al. Determining the optimal approach to breast reconstruction after partial mastectomy. Plast Reconstr Surg. 2006;117:1–11; discussion 12–4.Bajaj A. K., Kon P. S., Oberg K. C. et al. Aesthetic outcomes in patients undergoing breast conservation therapy for the treatment of localized breast cancer // Plast. Reconstr. Surg. 2004. Vol. 114. Р. 1442–1449.Bajaj A. K., Kon P. S., Oberg K. C. et al. Aesthetic outcomes in patients undergoing breast conservation therapy for the treatment of localized breast cancer. Plast Reconstr Surg. 2004;114:1442–1449.Munhoz A. M., Montag E., Arruda E. G. et al. Critical analysis of reduction mammaplasty techniques in combination with conservative breast surgery for early breast cancer treatment // Plast. Reconstr. Surg. 2006. Vol. 117. Р. 1091–1103. Doi: 10.1097/01.prs.0000202121.84583.0d.Munhoz A. M., Montag E., Arruda E. G. et al. Critical analysis of reduction mammaplasty techniques in combination with conservative breast surgery for early breast cancer treatment. Plast Reconstr Surg. 2006;117:1091–1103; discussion 1104–7. Doi: 10.1097/01. prs.0000202121.84583.0d.Chauhan A., Sharma M. M. Evaluation of surgical outcomes following oncoplastic breast surgery in early breast cancer and comparison with conventional breast conservation surgery // Med. J. Armed. Forces India. 2016. Vol. 72, № 1. Р. 12–18. Doi: 10.1016/j.mjafi.2015.11.001.Chauhan A., Sharma M. M. Evaluation of surgical outcomes following oncoplastic breast surgery in early breast cancer and comparison with conventional breast conservation surgery. Med J Armed Forces India. 2016;72(1):12–18. Doi: 10.1016/j.mjafi.2015.11.001.Oncological advantages of oncoplastic breast-conserving surgery in treatment of early breast cancer / S. K. Down, P. K. Jha, A. Burger, M. I. Hussien // Breast J. 2013. Vol. 19, № 1. Р. 56–63. Doi: 10.1111/ tbj.12047.Down S. K., Jha P. K., Burger A., Hussien M. I. Oncological advantages of oncoplastic breast-conserving surgery in treatment of early breast cancer. Breast J. 2013;19(1):56–63. Doi: 10.1111/tbj.12047.Cil T. D., Cordeiro E. Complications of oncoplastic breast surgery involving soft tissue transfer versus breast-conserving surgery : an analysis of the NSQIP database // Ann. Surg. Oncol. 2016. Vol. 23. Р. 3266–3271. Doi: 10.1245/s10434-016-5477-8.Cil T. D., Cordeiro E. Complications of oncoplastic breast surgery involving soft tissue transfer versus breast-conserving surgery: an analysis of the NSQIP database. Ann Surg Oncol. 2016;23:3266–3271. Doi: 10.1245/s10434-016-5477-8.Dindo D., Demartines N., Clavien P. A. Classification of surgical complications : a new proposal with evaluation in a cohort of 6336 patients and results of a survey // Ann. Surg. 2004. Vol. 240, № 2. Р. 205–213.Dindo D., Demartines N., Clavien P. A. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–213.Panhofer P., Ferenc V., Schutz M. et al. Standardization of morbidity assessment in breast cancer surgery using the clavien dindo classification // Int. J. Surg. 2014. Vol. 12, № 4. Р. 334–339. Doi: 10.1016/j. ijsu.2014.01.012.Panhofer P., Ferenc V., Schutz M. et al. Standardization of morbidity assessment in breast cancer surgery using the clavien dindo classification. Int J Surg. 2014;12(4):334–339. Doi: 10.1016/j.ijsu.2014.01.012.Association of Breast Surgery, Consensus Statement of Excision Margins. URL: http://www.associationofbreastsurgery.org.uk/media/64, 822/ margins_statement_2015_final.pdf (дата обращения: 13.03.2017).Association of Breast Surgery, Consensus Statement of Excision Margins.Available at: http://www.associationofbreastsurgery.org uk/media/ 64,822/margins_statement_2015_final.pdf (accessed: 13.03.2017).Morrow M., Van Zee K. J., Solin L. J. et al. Society of Surgical OncologyAmerican Society for Radiation Oncology-American Society of Clinical Oncology Consensus Guideline on Margins for Breast-Conserving Surgery with whole-breast irradiation in ductal carcinoma in situ // J. Clin. Oncol. 2016. Vol. 34, № 33. Р. 4040–4046. Doi: 10.1016/j.prro.2016.06.011.Morrow M., Van Zee K. J., Solin L. J. et al. Society of Surgical OncologyAmerican Society for Radiation Oncology-American Society of Clinical Oncology Consensus Guideline on Margins for Breast-Conserving Surgery with whole-breast irradiation in ductal carcinoma in situ. J Clin Oncol. 2016;34(33):4040–4046. Doi: 10.1016/j.prro.2016.06.011.Losken A., Pinell-White X., Hart A. M. et al. The oncoplastic reduction approach to breast conservation therapy : benefits for margin control // Aesthet. Surg. J. 2014. Vol. 34. Р. 1185–1191. Doi: 10.1177/ 1090820X14545618.Losken A., Pinell-White X., Hart A. M. et al.The oncoplastic reduction approach to breast conservation therapy: benefits for margin control.Aesthet Surg J. 2014;34:1185–1191. Doi: 10.1177/ 1090820X14545618.Kaur N., Petit J. Y., Rietjens M. et al. Comparative study of surgical margins in oncoplastic surgery and quadrantectomy in breast cancer //Ann. Surg. Oncol. 2005. Vol. 12. Р. 539–545. Doi: 10.1245/ASO.2005.12.046.Kaur N., Petit J. Y., Rietjens M. et al. Comparative study of surgical margins in oncoplastic surgery and quadrantectomy in breast cancer. Ann Surg Oncol. 2005;12:539–545. Doi: 10.1245/ASO.2005.12.046.Giacalone P. L., Roger P., Dubon O. et al. Comparative study of the accuracy of breast resection in oncoplastic surgery and quadrantectomy in breast cancer // Ann. Surg. Oncol. 2007. Vol. 14. Р. 605–614. Doi: 10.1245/s10434-006-9098-5.Giacalone P. L., Roger P., Dubon O. et al. Comparative study of the accuracy of breast resection in oncoplastic surgery and quadrantectomy in breast cancer.Ann Surg Oncol. 2007;14:605–614. Doi: 10.1245/ s10434-006-9098-5.Houssami N., Macaskill P., Marinovich M. L. et al. Meta-analysis of the impact of surgical margins on local recurrence in women with early-stage invasive breast cancer treated with breast-conserving therapy // Eur. J. Cancer. 2010. Vol. 46, № 18. Р. 3219–3232. Doi: 10.1016/j. ejca.2010.07.043.Houssami N., Macaskill P., Marinovich M. L. et al. Meta-analysis of the impact of surgical margins on local recurrence in women with earlystage invasive breast cancer treated with breast-conserving therapy. Eur J Cancer. 2010;46(18):3219–3232. Doi: 10.1016/j.ejca.2010.07.043.Singletary S. E. Surgical margins in patients with early-stage breast cancer treated with breast conservation therapy // Am. J. Surg. 2002. Vol. 184, № 5. Р. 383–393.Singletary S. E. Surgical margins in patients with early-stage breast cancer treated with breast conservation therapy.Am J Surg. 2002;184(5):383–393.Chauhan A., Sharma M. M., Kumar K. Evaluation of surgical outcomes of oncoplasty breast surgery in locally advanced breast cancer and comparison with conventional breast conservation surgery // Indian J. Surg. Oncol. 2016. Vol. 7, № 4: Р. 413–419. Doi: 10.1007/s13193-016-0549-6.Chauhan A., Sharma M. M., Kumar K. Evaluation of surgical outcomes of oncoplasty breast surgery in locally advanced breast cancer and comparison with conventional breast conservation surgery. Indian J Surg Oncol. 2016;7(4):413–419. Doi: 10.1007/s13193-016-0549-6.Mazouni C., Naveau A., Kane A. et al. The role of oncoplastic breast surgery in the management of breast cancer treated with primary chemotherapy // Breast. 2013. Vol. 22, № 6. Р. 1189–1193. Doi: 10.1016/j.breast.2013.07.055.Mazouni C., Naveau A., Kane A. et al. The role of oncoplastic breast surgery in the management of breast cancer treated with primary chemotherapy. Breast. 2013;22(6):1189–1193. Doi: 10.1016/j.breast.2013.07.055.Mansell J., Weiler-Mithoff E., Stallard S. et al. Oncoplastic breast conservation surgery is oncologically safe when compared to wide local excision and mastectomy // Breast. 2017. Vol. 32. Р. 179–185. Doi: 10.1016/j.breast.2017.02.006.Mansell J., Weiler-Mithoff E., Stallard S. et al. Oncoplastic breast conservation surgery is oncologically safe when compared to wide local excision and mastectomy. Breast. 2017;32:179–185. Doi: 10.1016 / j.breast.2017.02.006.Bong J., Parker J., Clapper R. et al. Clinical series of oncoplastic mastopexy to optimize cosmesis of large-volume resections for breast conservation //Ann Surg. Oncol. 2010. Vol. 17. Р. 3247–3251. Doi: 10.1245/ s10434-010-1140-y.Bong J., Parker J., Clapper R. et al. Clinical series of oncoplastic mastopexy to optimize cosmesis of large-volume resections for breast conservation. Ann Surg Oncol. 2010;17:3247–3251. Doi: 10.1245/ s10434-010-1140-y.Chakravorty A., Shrestha A. K., Sanmugalingam N. et al. How safe is oncoplastic breast conservation? Сomparative analysis with standard breast conserving surgery // Eur. J. Surg. Oncol. 2012. Vol. 38, № 5. Р. 395–398. Doi: 10.1016/j.ejso.2012.02.186.Chakravorty A., Shrestha A. K., Sanmugalingam N. et al. How safe is oncoplastic breast conservation? Сomparative analysis with standard breast conserving surgery. Eur J Surg Oncol. 2012;38(5):395–398. Doi: 10.1016/j.ejso.2012.02.186.Gulcelik M. A., Dogan L., Yuksel M. et al. Comparison of outcomes of standard and oncoplastic breast-conserving surgery // J. Breast. Cancer. 2013. Vol. 16, № 2. Р. 193–197. Doi: 10.4048/jbc.2013.16.2.193.Gulcelik M. A., Dogan L., Yuksel M. et al. Comparison of outcomes of standard and oncoplastic breast-conserving surgery. J Breast Cancer. 2013;16(2):193–197. Doi: 10.4048/jbc.2013.16.2.193.De Lorenzi F., Hubner G., Rotmensz N. et al. Oncological results of oncoplastic breast-conserving surgery : long term follow-up of a large series at a single institution : a matched-cohort analysis // Eur. J. Surg. Oncol. 2016. Vol. 42, № 1. Р. 71–77. Doi: 10.1016/j.ejso.2015.08.160.De Lorenzi F., Hubner G., Rotmensz N. et al. Oncological results of oncoplastic breast-conserving surgery: long term follow-up of a large series at a single institution: a matched-cohort analysis. Eur J Surg Oncol. 2016;42(1):71–77. Doi: 10.1016/j.ejso.2015.08.160.Caruso F., Ferrara M., Castiglione G. et al. Therapeutic mammaplasties : full local control of breast cancer in one surgical stage with frozen section // Eur. J. Surg. Oncol. 2011. Vol. 37. Р. 871 – 875. Doi: 10.1016/j. ejso.2011.07.002.Caruso F., Ferrara M., Castiglione G. et al. Therapeutic mammaplasties: full local control of breast cancer in one surgical stage with frozen section.Eur J Surg Oncol. 2011;37:871–875. Doi: 10.1016/j.ejso.2011.07.002.Rusby J. E., Paramanathan N., Laws S. A. et al. Immediate latissimus dorsi miniflap volume replacement for partial mastectomy : use of intra-operative frozen sections to confirm negative margins // Am. J. Surg. 2008. Vol. 196. Р. 512–518. Doi: 10.1016/j.amjsurg.2008.06.026 10.1016/j.amjsurg.2008.06.026.Rusby J. E., Paramanathan N., Laws S. A. et al. Immediate latissimus dorsi miniflap volume replacement for partial mastectomy: use of intra-operative frozen sections to confirm negative margins. Am J Surg. 2008;196:512– 518. Doi: 10.1016/j.amjsurg.2008.06.026 10.1016/j.amjsurg.2008.06.026.Darby S., McGale P., Correa C. et al. Effect of radiotherapy after breastconserving surgery on 10-year recurrence and 15-year breast cancer death : meta-analysis of individual patient data for 10801 women in 17 randomized trials // Lancet. 2011. Vol. 378, № 9804. Р. 1707–1716. Doi: 10.1016/S0140-6736(11)61629-2.Darby S., McGale P., Correa C. et al. Effect of radiotherapy after breastconserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10801 women in 17 randomized trials. Lancet. 2011;378(9804):1707–1716. Doi: 10.1016/ S0140-6736(11)61629-2.Lowery A. J., Kell M. R., Glynn R. W et al. Locoregional recurrence after breast cancer surgery : a systematic review by receptor phenotype // Breast Cancer Res. Treat. 2012. Vol. 133, № 3. Р. 831–841. Doi: 10.1007/s10549-011-1891-6.Lowery A. J., Kell M. R., Glynn R. W et al. Locoregional recurrence after breast cancer surgery: a systematic review by receptor phenotype. Breast Cancer Res Treat. 2012;133(3):831–841. Doi: 10.1007/ s10549-011-1891-6.De Lorenzi F., Loschi P., Bagnardi V. et al. Oncoplastic breast-conserving surgery for tumors larger than 2 centimeters : is it oncologically safe? A matched-cohort analysis // Ann. Surg. Oncol. 2016. Vol. 23, № 6. Р. 1852–1859. Doi: 10.1245/s10434-016-5124-4.De Lorenzi F., Loschi P., Bagnardi V. et al. Oncoplastic breast-conserving surgery for tumors larger than 2 centimeters: is it oncologically safe? A matched-cohort analysis.Ann Surg Oncol. 2016;23(6):1852–1859. Doi: 10.1245/s10434-016-5124-4.Haloua M. H., Krekel N. M., Winters H. A. et al. A systematic review of oncoplastic breast-conserving surgery : current weaknesses and future prospects // Ann. Surg. 2013. Vol. 257, № 4. Р. 609–620. Doi: 10.1097/ SLA.0b013e3182888782.Haloua M. H., Krekel N. M., Winters H. A. et al. A systematic review of oncoplastic breast-conserving surgery: current weaknesses and future prospects. Ann Surg. 2013;257(4):609–620. Doi: 10.1097/SLA. 0b013e3182888782.Hage J. A. van der, Velde C. J. van de, Julien J. P. et al. Preoperative chemotherapy in primary operable breast cancer : results from the European Organization for Research and Treatment of Cancer trial 10902 // J. Clin. Oncol. 2001. Vol. 19. Р. 4224–4237. Doi: 10.1200/JCO.2001.19.22.4224.van der Hage J. A., van de Velde C. J., Julien J. P. et al. Preoperative chemotherapy in primary operable breast cancer: results from the European Organization for Research and Treatment of Cancer trial 10902. J Clin Oncol. 2001;19:4224–4237. Doi: 10.1200/JCO.2001.19.22.4224.Chang E., Johnson N., Webber B. et al. Bilateral reduction mammoplasty in combination with lumpectomy for treatment of breast cancer in patients with macromastia // Am. J. Surg. 2004. Vol. 187. Р. 647-650. Doi: 10.1016/j.amjsurg.2004.01.002.Chang E., Johnson N., Webber B. et al. Bilateral reduction mammoplasty in combination with lumpectomy for treatment of breast cancer in patients with macromastia. Am J Surg. 2004;187:647-650. Doi: 10.1016/j.amjsurg.2004.01.002.Newman L. A., Kuerer H. M., McNeese M. D. et al. Reduction mammoplasty improves breast conservation therapy in patients with macromastia // Am. J. Surg. 2001. Vol. 181. Р. 215–220.Newman L. A., Kuerer H. M., McNeese M. D. et al. Reduction mammoplasty improves breast conservation therapy in patients with macromastia. Am J Surg. 2001;181:215–220.Veiga D. F., Veiga-Filho J., Ribeiro L. M. et al. Evaluations of aesthetic outcomes of oncoplastic surgery by surgeons of different gender and specialty : a prospective controlled study // Breast. 2011. Vol. 20. Р. 407–412. Doi: 10.1016/j.breast.2011.04.001.Veiga D. F., Veiga-Filho J., Ribeiro L. M. et al. Evaluations of aesthetic outcomes of oncoplastic surgery by surgeons of different gender and specialty: a prospective controlled study. Breast. 2011;20:407–412. Doi: 10.1016/j.breast.2011.04.001.Brédart A., Petit J. Y. Partial mastectomy : a balance between oncology and aesthetics? // Lancet Oncol. 2005. Vol. 6. Р. 130. Doi: 10.1016/ S1470-2045(05)01747-X.Brédart A., Petit J. Y. Partial mastectomy: a balance between oncology and aesthetics? Lancet Oncol. 2005;6:130. Doi: 10.1016/S1470- 2045(05)01747-X.Clough K. B., Lewis J. S., Couturaud B. et al. Oncoplastic techniques allow extensive resections for breast-conserving therapy of breast carcinomas // Ann. Surg. 2003. Vol. 237. Р.26–34. Doi: 10.1097/01.SLA. 0000041230.77663.22.Clough K. B., Lewis J. S., Couturaud B. et al. Oncoplastic techniques allow extensive resections for breast-conserving therapy of breast carcinomas. Ann Surg. 2003;237:26–34. Doi: 10.1097/01.SLA. 0000041230.77663.22.Spear S. L., Pelletiere C. V., Wolfe A. J. et al. Experience with reduction mammaplasty combined with breast conservation therapy in the treatment of breast cancer // Plast. Reconstr. Surg. 2003. Vol. 111. Р. 1102–1109. Doi: 10.1097/01.PRS.0000046491.87997.40.Spear S. L., Pelletiere C. V., Wolfe A. J. et al. Experience with reduction mammaplasty combined with breast conservation therapy in the treatment of breast cancer. Plast Reconstr Surg. 2003;111:1102–1109. Doi: 10.1097/01.PRS.0000046491.87997.40.

The authors declare that there are no conflicts of interest present.