Oncoplastic Surgery for Upper/Upper Inner Quadrant Breast Cancer

• Published in: PloS one 2016-12, Vol.11 (12), p.e0168434-e0168434
• Main Authors: Lin, Joseph, Chen, Dar-Ren, Wang, Yu-Fen, Lai, Hung-Wen
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Breast cancer; Breast implants; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Breast reconstruction; Breasts; Cancer; Cancer therapies; Care and treatment; Conservation; Female; Hospitals; Humans; Lumpectomy; Mammaplasty - methods; Mastectomy; Mastectomy, Segmental - methods; Medical diagnosis; Medical records; Medicine and Health Sciences; Methods; Middle Aged; Neoplasm Staging; Nipples - surgery; Patients; Postoperative Period; Prostheses; Radiation therapy; Retrospective Studies; Self image; Surgeons; Surgery; Surgical implants; Treatment Outcome; Tumors
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0168434

Tumors located in the upper/upper inner quadrant of the breast warrant more attention. A small lesion relative to the size of breast in this location may be resolved by performing a level I oncoplastic technique. However, a wide excision may significantly reduce the overall quality of the breast shape by distorting the visible breast line. From June 2012 to April 2015, 36 patients with breast cancer located in the upper/upper inner quadrant underwent breast-conservation surgery with matrix rotation mammoplasty. According to the size and location of the tumor relative to the nipple-areola complex, 11 patients underwent matrix rotation with periareolar de-epithelialization (donut group) and the other 25 underwent matrix rotation only (non-donut group). The cosmetic results were self-assessed by questionnaires. The average weights of the excised breast lumps in the donut and non-donut groups were 104.1 and 84.5 g, respectively. During the 3-year follow-up period, local recurrence was observed in one case and was managed with nipple-sparing mastectomy followed by breast reconstruction with prosthetic implants. In total, 31 patients (88.6%) ranked their postoperative result as either acceptable or satisfactory. The treated breasts were also self-evaluated by 27 patients (77.1%) to be nearly identical to or just slightly different from the untreated side. Matrix rotation is an easy breast-preserving technique for treating breast cancer located in the upper/upper inner quadrant of the breast that requires a relatively wide excision. With this technique, a larger breast tumor could be removed without compromising the breast appearance.