Journal of Medical Oncology and Therapeutics

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Novel surgical options in breast cancer

International Conference on Oncology & Cancer Therapy
March 18-19, 2019 | London, UK

Diane M Radford

Cleveland Clinic Foundation, USA

Scientific Tracks Abstracts : J Med Oncl Ther


This talk focuses on advances in oncoplastic surgery techniques for breast cancer, and surgical methods to reduce lymphedema. Nipple-sparing mastectomy (NSM) in the United States was first described by Drs. Joseph Crowe and Randall Yetman of the Cleveland Clinic (CCF) in 2004. Incision placement for the procedure can be inframammary, periareolar, lateral, upper outer quadrant, lateral with a periareolar extension, medial, and transareolar. When the tumor is superficial in location, preserving the skin anterior to the tumor can compromise the oncologic goal of clear margins. The technique of Tumor Ultrasound-guided Incision (TUGI) for NSM developed by Dr. Stephen Grobmyer and colleagues at CCF overcomes this problem. The techniques employs intraoperative ultrasound to locate the tumor and delineate the skin overlying it. The incision is then based on the tumor location, removing the skin anterior to the tumor en bloc with the NSM. This approach balances oncologic safety and technical outcomes. Lymphedema is the nemesis of axillary nodal surgery for breast cancer, impacting patient quality of life and resulting in significant functional, psychological, and social morbidity. Although the increased use of sentinel node biopsy, either when nodes are clinically negative, or following neo-adjuvant therapy (NAC), has resulted in lower lymphedema rates, the rates following full axillary dissection can be up to 77%. Techniques to reduce lymphedema include axillary reverse mapping (ARM), meticulous dissection of arm lymphatics with loupe magnification, microsurgical lymphaticovenous bypass, and a triple mapping technique following NAC which incorporates Indocyanine Green (ICG) fluorescence for sentinel node bypass.


Diane M Radford is a staff breast surgical oncologist with the Cleveland Clinic in Cleveland, Ohio, and Director of the Breast Program at Cleveland Clinic Hillcrest Hospital. Originally from Scotland, she trained on both sides of the Atlantic, including the Professorial Unit, Royal Infirmary of Edinburgh, the Western Infirmary, Glasgow, and St. Louis University. She has completed fellowships in Surgical Oncology (Roswell Park Cancer Institute) and Integrative Medicine (University of Arizona). Her peers have recognized her as a Best Doctor every year since 1996 as well as a Top Doctor nationally. She has authored numerous peerreviewed journal articles and textbook chapters. Active on social media since 2011, she has lectured nationally and internationally on social media for health care professionals including at the Harvard course “Achieving Healthcare Leadership and Outcomes Through Writing, Publishing, and Social Media,” and at the American Society of Breast Surgeons annual meeting. She participates in the tweet chat #bcsm (breast cancer social media) and has been featured as a guest expert. She serves on the Editorial Board of the Annals of Surgical Oncology, Multi-Media section, and co-authored a guide for other members of the board on how to use Twitter. Her Twitter followers number over 15,000. 

E-mail: [email protected]

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