Daily Cosmetic Research Analysis
Across breast cancer surgery and radiation, two studies emphasize techniques that preserve cosmetic outcomes without compromising safety: a systematic review supports single-incision breast-conserving surgery with sentinel node biopsy, and a prospective trial shows excellent cosmesis and control with hypofractionated IMRT partial breast irradiation. Additionally, an interdisciplinary recommendation addresses rising complications from hyaluronic acid filler injections.
Summary
Across breast cancer surgery and radiation, two studies emphasize techniques that preserve cosmetic outcomes without compromising safety: a systematic review supports single-incision breast-conserving surgery with sentinel node biopsy, and a prospective trial shows excellent cosmesis and control with hypofractionated IMRT partial breast irradiation. Additionally, an interdisciplinary recommendation addresses rising complications from hyaluronic acid filler injections.
Research Themes
- Oncoplastic surgical techniques that improve cosmesis
- Hypofractionated partial breast irradiation balancing control and toxicity
- Interdisciplinary safety management for aesthetic injectables
Selected Articles
1. Single breast incision for breast conservation surgery and sentinel lymph node biopsy: a systematic review.
This PRISMA-guided systematic review found that single-incision breast-conserving surgery with sentinel node biopsy is feasible across all breast quadrants. Compared with two-incision approaches, complications were similar, while patient satisfaction and postoperative axillary pain favored the single-incision technique.
Impact: The work consolidates evidence supporting a less invasive oncoplastic approach that can improve cosmetic outcomes without increasing complications.
Clinical Implications: Single-incision breast-conserving surgery with SLNB can be considered for tumors in any quadrant to minimize scars and pain while maintaining safety; however, long-term oncologic outcomes require further confirmation.
Key Findings
- Feasible single-incision access across all breast quadrants for BCS and SLNB
- Eight studies reported successful axillary dissection through a single incision
- Four comparative studies showed no difference in complication rates vs. two-incision techniques
- Single-incision approach improved patient satisfaction and reduced postoperative axillary pain
Methodological Strengths
- PRISMA-compliant comprehensive search across multiple databases
- Includes comparative studies assessing complications, pain, and cosmetic outcomes
Limitations
- Heterogeneity of included studies and techniques with limited standardization
- Lack of randomized trials and limited long-term oncologic outcome data
Future Directions: Prospective randomized trials with standardized cosmetic and quality-of-life metrics and long-term oncologic follow-up.
2. Hypofractionated partial breast irradiation after breast-conserving surgery for patients with early stage breast cancer in China Mainland: a single-arm prospective trial.
In 208 evaluable low-risk early breast cancer patients treated with IMRT-PBI (40.05 Gy in 15 fractions), 3-year cosmetic deterioration was 3.5%. Grade 2 dermatitis occurred in 5.8% and induration in 1.5%, with no ≥ grade 2 breast pain, edema, or telangiectasia. Five-year ipsilateral recurrence was 0.5%, DFS 99.0%, and OS 97.9%.
Impact: This registered prospective trial demonstrates excellent cosmesis and local control with a practical hypofractionated external beam PBI regimen.
Clinical Implications: For carefully selected low-risk patients after breast-conserving surgery, IMRT-PBI (40.05 Gy/15 fractions) is a compelling option balancing tumor control and cosmetic outcomes with low toxicity; comparative trials are needed to confirm equivalence vs. whole-breast irradiation.
Key Findings
- 3-year cosmetic deterioration rate was 3.5%
- Grade 2 dermatitis 5.8% and breast induration 1.5%; no ≥ grade 2 pain, edema, or telangiectasia
- 5-year ipsilateral breast tumor recurrence 0.5% and regional recurrence 0.5%
- No distant metastases; 5-year DFS 99.0% and OS 97.9% (4 non-breast cancer deaths)
Methodological Strengths
- Prospective, registered single-arm trial with prespecified cosmetic endpoint
- Adequate sample size (n=208) and median follow-up of 66.3 months
Limitations
- Single-arm design without a control group limits causal inference
- Restricted to low-risk population; generalizability may be limited
Future Directions: Head-to-head randomized trials versus whole-breast irradiation and other PBI schedules, with standardized patient-reported cosmetic outcomes and longer follow-up.
3. [Management of side effects following hyaluronic acid filler injections].
As hyaluronic acid filler use grows, complication management increasingly requires coordinated, interdisciplinary care. Based on three recent cases, the authors propose a joint action recommendation across dermatology, plastic surgery, oral and maxillofacial surgery, ENT, ophthalmology, and neurology.
Impact: Provides practical, interdisciplinary guidance addressing rising safety concerns in aesthetic medicine, where delayed or fragmented responses can worsen outcomes.
Clinical Implications: Centers offering fillers should establish rapid interdisciplinary pathways (dermatology, plastics, OMFS, ENT, ophthalmology, neurology) for timely assessment and management of complications.
Key Findings
- Complication risk rises with increasing hyaluronic acid filler procedures
- Interdisciplinary management is often necessary due to case complexity
- Three interdisciplinary cases informed a joint, multi-department recommendation
Methodological Strengths
- Real-world interdisciplinary case experience informing recommendations
- Consensus-building across six relevant specialties
Limitations
- Based on a small case series without standardized outcomes or comparative data
- Specific algorithms and efficacy metrics are not detailed in the abstract
Future Directions: Develop multicenter registries and standardized algorithms for vascular, ocular, and neurologic complications; prospectively evaluate time-to-intervention and outcomes.