Bilateral reduction mammoplasty in combination with lumpectomy for treatment of breast cancer in patients with macromastia

• Published in: The American journal of surgery 2004-05, Vol.187 (5), p.647-651
• Main Authors: Chang, Eugene, Johnson, Nathalie, Webber, Bruce, Booth, James, Rahhal, Dina, Gannett, David, Johnson, William, Franzini, Daisy, Zegzula, Henry
• Format: Article
• Language: English
• Subjects: Adenocarcinoma, Mucinous - complications; Adenocarcinoma, Mucinous - pathology; Adenocarcinoma, Mucinous - surgery; Adult; Aged; Biopsy; Biopsy, Needle; Breast; Breast cancer; Breast Neoplasms - complications; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Breasts; Carcinoma in Situ - complications; Carcinoma in Situ - pathology; Carcinoma in Situ - surgery; Carcinoma, Ductal - complications; Carcinoma, Ductal - pathology; Carcinoma, Ductal - surgery; Carcinoma, Lobular - complications; Carcinoma, Lobular - pathology; Carcinoma, Lobular - surgery; Female; Humans; Hypertrophy; Macromastia; Mammaplasty - adverse effects; Mammaplasty - methods; Mastectomy, Segmental - adverse effects; Mastectomy, Segmental - methods; Middle Aged; Neoplasm Staging; Patient Selection; Preoperative Care - methods; Reduction mammoplasty; Retrospective Studies; Risk Factors; Sentinel Lymph Node Biopsy - methods; Surgical Flaps; Therapy; Treatment Outcome; Tumors; Womens health
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2004.01.002

Bilateral reduction mammoplasty has been described as a surgical option for treatment of breast cancer in women with large, pendulous breasts. Using this technique can provide unique surgical oncologic challenges. Retrospective chart review. Thirty-seven patients were identified. The average weight of tissue removed was 653 g. Tumor size ranged from 0.6 to 5.2 cm. One patient had microscopically positive surgical margins on final pathology. The tumor bed was not marked, and completion mastectomy was required. Two patients had unexpected malignancy in the contralateral breast. One patient required completion mastectomy for positive nonoriented margins. In another patient, tissue from the contralateral side was oriented, and mastectomy was avoided. Bilateral reduction mammoplasty with lumpectomy is an ideal option in women with macromastia. We recommend marking the tumor bed on the flaps and pedicle as well as orienting tissue removed from the contralateral side as maneuvers that will decrease need for completion mastectomy.