ABSTRACT
The indications for immediate repair are similar to those for any oncoplastic procedure including large breasts, tumors in cosmetically sensitive locations, a large tumor-to-breast ratio, and the need for a generous resection. Delayed-immediate repair refers to performing breast oncoplastic repair within 1-3 weeks after the lumpectomy, but before radiotherapy. The decision for undertaking delayed-immediate repair is based on issues of oncologic safety and the availability of an experienced surgeon with knowledge of oncoplastic techniques, be this a plastic surgeon or breast surgeon with oncoplastic competency. Free surgical margins equal or greater than either 5 mm or 10 mm were obtained more frequently using oncoplastic surgery than standard breast-conservation surgery. Rearrangement of glandular tissue at the time of lumpectomy can make re-excision challenging because of the difficulty to locate the residual tumor. Delayed-immediate repair offers the benefits of an easier re-excision of the tumor cavity if positive margins are confirmed. This can often safely be performed at the time of reconstruction.
