Therapeutic reduction mammoplasty in large-breasted women with cancer using superior and superomedial pedicles

Abstract

Adel Denewer,1 Fayez Shahatto,1 Waleed Elnahas,1 Omar Farouk,1 Sameh Roshdy,1 Ashraf Khater,1 Osama Hussein,1 Saleh Teima,2 Mohammed Hafez,1 Samir Zidan,1 Nazem Shams,1 Sherif Kotb11Surgical Oncology Department, Oncology Center, 2Clinical Oncology and Nuclear Medicine Department, Mansoura University, Mansoura, EgyptBackground: Surgical management of breast cancer in large-breasted women presents a real challenge. This study aims to evaluate the outcome of therapeutic reduction mammoplasty in large-breasted women with breast cancer using superior and superomedial pedicles, situated at any breast quadrant except for the central and upper medial quadrants.Methods: Fifty women with breast cancer and large breasts underwent simultaneous bilateral reduction mammoplasty. The weight of the tissue removed ranged from 550 g to 1050 g and the tumor-free safety margins by frozen section were in the range of 4 cm to 12 cm.Results: The age of the patients ranged from 36 to 58 (median 43) years and tumor size ranged from 1 cm to 4 cm. The cosmetic outcomes were excellent in 32 patients (64%), good in 15 (30%) patients, and fair in three patients (6%). The follow-up period was 8–36 (mean 20) months, with no local recurrence or systemic metastasis.Conclusion: Therapeutic reduction mammoplasty using superior and superomedial pedicles was shown to be oncologically safer than traditional conservative surgery. This oncoplastic procedure yields a satisfactory esthetic outcome with lower morbidity in large-breasted women with breast cancer.Keywords: breast cancer, oncoplastic surgery, reduction mammoplasty, conservation surgery