الفهرس 
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Abstract
The goal of modern breast surgery is to cure patients with preservation of breast tissue as much as possible with satisfactory physical and psychological outcome. This goal has led to introduction of a new scope of surgery into our clinical practice called oncoplastic breast surgery, with the advantage of combining oncological safety and satisfactory cosmetic outcome.
There are two fundamental different approaches for oncoplastic surgery dedicated for breast cancers at the upper outer quadrant. First are the volume displacement techniques, second are volume replacement techniques. Volume displacement techniques include donut mammoplasty, lateral mammoplasty and radial segmentectomy.
In our study we addressed the three oncoplastic volume displacement techniques in a prospective study conducted over 30 patients that aimed to demonstrate the safety of those techniques and the comparable outcomes as regard pre and post-operative prospectives.
Donut mammoplasty had the highest cosmetic outcome score for the incision being obscured at the periareolar transitional zone. It was best applied to small sized breast (Cup A,B and C), however we don’t recommend to approach a large sized breast with possibly distant tumor from the NAC with the donut mammoplasty technique as it will yield less satisfactory cosmetic outcome due to more dissection and hence depression of the breast mound. It had an average intra-and post-operative parameters like operation time, intra-operative blood loss, post-operative drain amount and post-operative hospital stay which was attributed to the simplicity of the technique.
Lateral mammoplasty fits a large sized breast (Cup D, E, F and G) with tumor at any distance from the NAC. It is a complex surgical technique which was reflected on the intra and post-operative parameters. Lateral mammoplasty had the longest operation time and largest amount of intra operative blood loss, post-operative drain amount and the longest post-operative hospital stay. For the same reason we don’t recommend this technique for diabetic patients, as the degree of dissection and size of the wound along with immune compromisation occurring with diabetes mellitus would hinder wound healing and raise the incidence of wound complications. In the other hand the cosmetic outcome was average and scored (Good) but definitely not comparable to either donut mammoplasty or radial segmentectomy.
Radial segmentectomy had the superiority of fitting any size of the breast (with exception of a very small breast cup A) and was the simplest technique in our study thus had the shortest operation time and least amount of intra-operative blood loss and post-operative drain amount. Also the incision being directed radially placed on the upper outer quadrant parallel to the line of axillary tail was cosmetically accepted and satisfactory.
During our follow up period we had only 5 cases of complications 3 cases of infection and 2 cases of hematoma. The overall incidence of complications in our study was 16% which is quite similar to the other comparable studies.
The oncological safety of our techniques was the same as the conventional conservative mastectomy, however the overall cosmetic outcome of our study was more satisfactory which was reflected on the patient psychological health and self well-being.