An optimized technique for all quadrant oncoplasty in women with small- to medium-sized breasts

D.-R. Chen

Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua, Taiwan.darren_chen@cch.org.tw

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• Oncology

BACKGROUND: Oncoplastic surgery is a method to extend the possibility of breast-preserving surgery that can avoid breast deformities and reduce both mastectomy and re-excision rates. Round-block mammoplasty is reported as an alternative method in mammary reductions.

AIM: In this study, the round-block mammoplasty was modified and presented as a better surgical choice for all quadrant-located cancers in small- to medium-sized breasts with good aesthetic results.

PATIENTS AND METHODS: From June to December 2011, 30 patients with T1-T2 breast lesions that were candidate for breast conserving surgery underwent this kind of surgery.

RESULTS: Only half of breast skin envelope development was necessary compared to conventional round-block mammoplasty techniques. Those excised specimens weighed 35 g on average, with the biggest one measuring 7x6x3 cm in a medium-sized breast without deformity. No drains were placed after surgery and only one patient had a seroma formation that needed to be aspirated. Half-breast dissection between the glandular tissue and subcutaneous fat instead of whole breast dissection is enough to reach a good operative field, lower the possibility of post-operative seroma and decrease the amount of operation time. To avoid the nipple areolar complex widening, a monofilament purse-string suture was used to reduce its diameter. Besides, radiation therapy did not affect the cosmetic outcome after a short-term follow-up.

CONCLUSIONS: Compared to whole breast dissection, half-breast dissection between glandular tissue and subcutaneous fat is enough to reach a good operative field, lowers the possibility of post-operation seroma and reduces the operation time. This method is recommended to be used to help improve the cosmetic results of breast surgery.