[Oncoplastic surgery for breast cancer]

Oncoplastic breast surgery combines carcinological excision and plastic surgery techniques to reduce the iatrogenic sequelae of breast cancer treatment and extend the indications for conservative surgery. In France, conservative treatment (lumpectomy and radiotherapy) is performed in 70% of cases, with survival rates similar to those obtained with mastectomy. Nearly 20% of these patients develop aesthetic after-effects. Oncoplasty not only reduces these after-effects but also extends the possibilities of breast conservation to larger tumors. Oncoplasty is classified into two levels: (1) level I: resections<20% of breast volume with glandular transfer, without skin resection and (2) level II: resections>20%, requiring breast reduction techniques with reduction of the skin sheath. Mammoplasty techniques vary according to tumour location ("atlas quadrant by quadrant"). For resections of external and inferior tumors, perforator flaps based on intercostal perforators (LICAP, AICAP), or terminal branches of axillary vessels (LTPA, TDAP) can also be used. CONCLUSION: Oncoplasty has transformed breast cancer management, optimizing both oncological safety and patient quality of life.