الفهرس 
Breast anatomyOnly 14 pages are availabe for public view
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Abstract
Breast cancer is the most common cancer in women and the second leading cause of women mortalitiy from cancer all over the world.
Oncoplastic techniques are replacing WLE technique for better cosmetic outcomes and better exposure of the tumor.
The Wise pattern may represent a versatile oncoplastic manoeuvre enabling the strategic rearrangement of breast tissue to address tumours situated in diverse anatomical locations.
This study aimed to compare between the Wise pattern therapeutic mammoplasty and wide local excision in treatment of upper and lower poles breast tumors regarding cosmetic results, oncological outcomes, complications, recurrence and degree of satisfaction of the patients.
This prospective comparative study was carried out on 40 patients presented with upper or lower pole breast cancer and completed their neo-adjuvant treatment at the breast cancer unit at Ain Shams University Hospitals. They were divided into two groups: Wise pattern therapeutic mammoplasty group: 20 patients underwent Wise pattern therapeutic mammoplasty (including superior and inferior pedicles). Wide local excision group: 20 patients underwent direct wide local excision.
The results of our present study can be summarized as follows:
• The mean age for the Wise pattern mammoplasty group was 37.4 ± 4.19 years. For the wide local excision group, the mean age was 38.8 ± 3.99 years. Age, BMI, size of the breast and ASA physical status were insignificantly different between the studied groups.
• In the Wise pattern mammoplasty group, 5 out of 20 patients (25%) had hypertension, while 2 out of 20 patients (10%) had diabetes mellitus. In the wide local excision group, 4 out of 20 patients (20%) had hypertension, and 4 out of 20 patients (20%) had diabetes mellitus. HTN, and DM were insignificantly different between the studied groups.
• Tumor side, tumor site, tumor grade, T stage, N stage, and NACT response were insignificantly different between the studied groups.
• Duration of surgery was significantly increased in Wise patten therapeutic mammoplasty technique than wide local excision technique (129.5 ± 25.54; 91.75 ± 20.15 respectively) (P value < 0.001).
• Resection weight was significantly increased in Wise pattern than WLE.
• Unviable NAC, wound infection and seroma were insignificantly different between the studied groups.
• Recurrence was insignificantly different between Wise patten therapeutic mammoplasty technique and wide local excision technique (P value = 0.5533).
• Satisfaction was significantly better in Wise pattern therapeutic mammoplasty technique than wide local excision technique (P value = 0.024).
Based on the results of our study, the Wise pattern therapeutic mammoplasty technique demonstrated superior outcomes compared to wide local excision for the treatment of upper and lower pole breast tumors. Although the groups were comparable in terms of age, comorbidities, tumor characteristics, and surgical
factors such as complication rates, the Wise pattern therapeutic mammoplasty technique had higher patient satisfaction scores. Additionally, despite a longer duration of surgery, the Wise pattern.
therapeutic mammoplasty technique did not result in increased complications such as non-viable nipple-areolar complex, wound infection or seroma compared to wide local excision. Therefore, the Wise pattern therapeutic mammoplasty technique appears to be a favorable surgical option for the management of upper and lower pole breast tumors, offering better oncological outcomes and improved cosmetic results with high patient satisfaction, without compromising safety or increasing morbidity.
Further studies with large number of patients should be done to support our results for better outcome.