[Oncoplastic breast surgery for the management of XXXX in situ].

@entity1 @entity0 @entity5 @entity16 @entity513
UNASSIGNED: DCIS ( @entity513 in situ) constitutes 15,2% of @entity0 . Conservative surgery coupled with adjuvant radiotherapy is often recommended. The rate of revision surgery is high, from 30 to 60%. The concern is a high quality resection within clear margins with a satisfactory aesthetic result. The objective of this review is to precise the place of oncoplastic surgery in DCIS care. Among risk factors of recurrence, tumoral invasion of surgical margins is capital. In histology, clear margins usually adopted for DCIS are 2mm, even though there is no international consensus. Recent studies show that a 10mm limit would be better. @entity16 caused by surgery, often increased by radiotherapy, has a negative impact on @entity1 quality of life  : oncoplastic surgery may minimize it. Techniques of plastic surgery, arranged into level 1 and 2, allow pushing back conservative treatment limits by removing a larger @entity5 with clear margins. Often used in invasive @entity5 , few data exist regarding oncoplastic surgery and DCIS. It allows to increase the dimensions of surgical resection by 20% and to decrease positive margins significantly therefore the rate of revision surgeries. @entity1 are satisfied with it. Specific indications need to be clarified according to age, size and "comedonecrosis" presence. Oncoplastic surgery should be developed in DCIS specific care.
