Therapeutic reduction mammoplasty techniques in management of breast cancer in large-breasted females – a comparative study between inferior and superior pedicle reduction mammoplasty

Mohsen, Sherief M

doi:10.4103/ejs.ejs_89_17

Cited by 4 publications

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“…Oncoplastic techniques in breast cancer treatment permits increasing indications of breastconservative surgery and improving cosmetic outcomes. Oncoplastic breast surgery is safe in terms of local recurrence and survival rates and is comparable to traditional breast-conserving surgery [8] . Thus, oncoplastic breast surgery offers a meet half way between the traditional BCS & mastectomy.…”

Section: Discussionmentioning

confidence: 97%

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Oncoplastic Surgery for Upper Inner Quadrant Breast Cancer: A Comparative Study between Two Oncoplastic Techniques

HOSSAM¹,

ELZAHABY

2022

The Medical Journal of Cairo University

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Background: Oncoplastic techniques in breast cancer therapy allows for extending the indications of breastconservative surgery plus improving cosmetic outcomes. Breast tumors located at the upper inner quadrant particularly represent a challenge for conservative surgery due to the scarcity of breast tissue and the risk of skin involvement. Aim of Study:This study aims to compare the outcomes of inferior pedicle mammoplasty and matrix rotation flap in medium-sized to large-breasted females with breast cancer located in the upper inner quadrant.Patients and Methods: From August 2013 to August 2021, 27 females patients with medium-sized to large-sized breasts diagnosed with early upper inner quadrant breast cancer and suitable for breast conservation underwent therapeutic mammoplasty depending on either inferior pedicle technique (group I) or matrix rotation mammoplasty technique (group II). Patients with multicentric breast cancer and those with persistent involved resection margins after excision were excluded from the study. Surgical outcomes, oncologic safety, and cosmetic results were assessed and compared between both groups.Results: There is significant difference between the two groups as regards the operative time, intraoperative blood loss, hospital stay, postoperative complications, cosmetic outcome and the need for contralateral symmetrization. Inferior pedicle mammaplasty needs longer operative time and postoperative hospital stay with more intraoperative blood loss in comparison to matrix rotation mammoplasty. As regards the postoperative complications, we found that there are more complications in inferior pedicle mammaplasty than matrix rotation mammoplastyas wound infection and nipple areola ischemia. Conclusion:Patients with early breast cancer located in the upper inner quadrant are candidate for either inferior pedicle mammoplasty or matrix rotation mammoplasty. Matrix rotation mammoplasty is better in some concerns as there is less morbidity, no need for contralateral symmetrization and fewer complications, so no delay in radiotherapy.

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Section: Discussionmentioning

confidence: 97%

“…Thus, oncoplastic breast surgery offers a meet half way between the traditional BCS & mastectomy. It permits larger excisions, hence decreasing the rate for positive margins, and expand the spectrum for CBS [8,9] . Each breast quadrant can by addressed by several techniques; however, the upper inner quadrant represents a real challenge.…”

Section: Discussionmentioning

confidence: 99%

Oncoplastic Surgery for Upper Inner Quadrant Breast Cancer: A Comparative Study between Two Oncoplastic Techniques

HOSSAM¹,

ELZAHABY

2022

The Medical Journal of Cairo University

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“…By applying breast reduction techniques to the field of breast cancer surgery, therapeutic breast mammoplasty can achieve more acceptable aesthetic and functional outcomes by reducing breast size, minimizing the significant impact of radiotherapy and achieving a preferred breast size and shape [5]. It also allows wide margins of excision improving oncological safety [6] and is associated with fewer aesthetic complications [7].…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Reduction Mammoplasty: Experience of a Single Institute

Azevedo¹,

Chaves²,

Coelho³

et al. 2023

Cureus

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Introduction: Breast cancer is the most common malignancy in women worldwide as reported by the World Health Organization. The concept of oncoplastic breast surgery appeared as an extension of breastconserving surgery, applying breast reduction techniques with more acceptable aesthetic and functional outcomes. The purpose of the present study was to describe the breast cancer population of a single institute submitted to lumpectomy and bilateral immediate breast reduction or mastopexy and its complications.Material and Methods: This is a retrospective observational study including patients submitted to lumpectomy and immediate bilateral breast reduction or mastopexy. Patients and tumour characteristics, surgical technique, complications, follow-up period, and recurrence data were obtained and analyzed.Results: A total of 49 patients were submitted to lumpectomy and bilateral breast therapeutic reduction/mastopexy, with a mean age of 56.47 ±8.58 years and a mean body mass index of 28.68kg/m 2 ±3.94 kg/m² between January 2019 and December 2021. Invasive tumours of no specific type, associated or not, with carcinoma intraductal in situ were the most common histological type corresponding to almost 80% of the cases with T1 stage corresponding to more than half of the cases. Sixteen percent of the patients had early minor complications with wound dehiscence associated with wound delayed healing, corresponding to 75% of the cases. Body mass index had a statistical difference between groups (p=0,006, ttest).Conclusions: The low rates of minor and major complications show that immediate therapeutic breast reduction can be a suitable approach in selected cases.

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“…TM combines the advantages of an oncologically safe wide excision of the tumor with breast reduction, mastopexy, and contralateral symmetrization techniques (20)(21)(22). In addition, TM has been shown to achieve satisfactory outcomes by reducing breast size, thereby facilitating better delivery and distribution of RT regimens, achieving contralateral breast symmetry, and improving the QoL (23). TM is reported to have recurrence rates of between 0% and 9% and shows oncological outcomes comparable to those of BCS (24-26).…”

Section: Introductionmentioning

confidence: 99%

Therapeutic mammoplasty: a “wise” oncoplastic choice—lessons from the largest single-center cohort from Asia

et al. 2023

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IntroductionThe majority of breast cancer patients from India usually present with advanced disease, limiting the scope of breast conservation surgery. Therapeutic mammoplasty (TM), an oncoplastic technique that permits larger excisions, is quite promising in such a scenario and well suited to breast cancer in medium-to-large-sized breasts with ptosis and in some cases of large or multifocal/multicentric tumors. Here, we describe our TM cohort of 205 (194 malignant and 11 benign) patients from 2012 to 2019 treated at a single surgeon center in India, the largest Asian dataset for TM.MethodsAll patients underwent treatment after careful discussions by a multidisciplinary tumor board and patient counseling. We report the clinicopathological profiles and surgical, oncological, cosmetic, and patient-related outcomes with different TM procedures.ResultsThe median age of breast cancer patients was 49 years; that of benign disease patients was 41 years. The breast cancer cohort underwent simple (n = 84), complex (n = 71), or extreme (n = 44) TM surgeries. All resection margins were analyzed through intra-operative frozen-section assessment with stringent rad-path analysis protocols. The margin positivity rate was found to be 1.4%. A majority of the cohort was observed to have pT1–pT2 tumors, and the median resection volume was 180 cc. Low post-operative complication rates and good-to-excellent cosmetic scores were observed. The median follow-up was 39 months. We observed 2.07% local and 5.7% distal recurrences, and disease-specific mortality was 3.1%. At median follow-up, the overall survival was observed to be 95.9%, and disease-free survival was found to be 92.2%. The patient-reported outcome measures (PROMs) showed good-to-excellent scores for all types of TMs across BREAST-Q domains.ConclusionWe conclude that in India, a country where women present with large and locally advanced tumors, TM safely expands the indications for breast conservation surgery. Our results show oncological and cosmetic outcomes at acceptable levels. Most importantly, PROM scores suggest improved overall wellbeing and better satisfaction with the quality of life. For patients with macromastia, this technique not only focuses on cancer but also improves self-image and reduces associated physical discomfort often overlooked by women in the Indian setting. The popularization of this procedure will enable Indian patients with breast cancer to receive the benefits of breast conservation.

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Therapeutic reduction mammoplasty techniques in management of breast cancer in large-breasted females – a comparative study between inferior and superior pedicle reduction mammoplasty

Cited by 4 publications

References 0 publications

Oncoplastic Surgery for Upper Inner Quadrant Breast Cancer: A Comparative Study between Two Oncoplastic Techniques

Oncoplastic Surgery for Upper Inner Quadrant Breast Cancer: A Comparative Study between Two Oncoplastic Techniques

Therapeutic Reduction Mammoplasty: Experience of a Single Institute

Therapeutic mammoplasty: a “wise” oncoplastic choice—lessons from the largest single-center cohort from Asia

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