Burow’s triangle advancement flap: a reliabletool on oncoplastic breast-conserving surgery

Abstract

Oncoplastic techniques in breast cancer treatment allow increasing indications of breast-conserving surgery and improving cosmetic results. Breast tumors located at the superior edge of the upper quadrant or at the upper inner quadrant represent a challenge for conservative surgery due to insufficient breast thickness and risk of skin involvement. We present a modified Burow's triangle advancement flap for breast-conserving surgery in patients with breast tumors at these locations. This retrospective observational study analyzed 8 out of 213 patients submitted to major oncoplastic breast procedures, who underwent breast-conserving surgery with matrix rotation mammaplasty, using a modified Burow's triangle advancement flap. All patients were treated in public and private health systems in Santiago, Chile. The median age at diagnosis was 47 years. The average initial tumor size was 5.9 cm, and the mean excised breast weight was 117 g. Patients required neither symmetrization nor displacement of the nipple-areola complex. Only one patient had a minor complication (wound dehiscence). During follow-up, no local recurrences were reported. We conclude that the modified Burow's triangle advancement flap is a safe and effective technique to manage tumors at this complex location. It provides adequate oncological margins, good cosmetic results, and contralateral symmetry, with complication rates similar to those of standard conservative surgery.

Aesthetic and surgical outcomes of the modified matrix rotation technique for upper inner quadrant breast tumors: a case series

“…The main disadvantage of this technique is the need to excise the skin anterior to the tumor even when it is oncologically clear. This results in an unsightly scar crossing over the UIQ and appearing on the visible breast line 4,12 (Figure 2). Because the UIQ is a cosmetically sensitive area for most patients, a minimum scar or deformity is the preferable outcome.…”

“…The main disadvantage of this technique is the need to excise the skin anterior to the tumor even when it is oncologically clear. This results in an unsightly scar crossing over the UIQ and appearing on the visible breast line 4,12 (Figure 2).…”