ABSTRACT
Oncoplastic techniques continue to advance the limits of breast-conservation surgery by permitting larger volumes of tissue to be excised while yielding an acceptable cosmetic result. The diagnosis of ductal carcinoma in situ (DCIS) has risen in the era of modern mammography, necessitating a coordinated approach between the oncologic resection and possible subsequent oncoplastic reconstruction. Oncoplastic planning will be influenced by a variety of factors including the type of oncologic surgical resection performed, the utilization or elimination of radiotherapy from the treatment algorithm, and methods for assessing DCIS margin status. The oncologic surgical approach to DCIS has traditionally been determined by factors such as tumor size and pathologic classification, age, and patient or provider choice or concern for risk of recurrence and desire to avoid repeat intervention. The optimum choice will be determined by breast size and percentage breast excision together with tumor location, need for re-excision, degree of ptosis, and timing of radiotherapy.
