Therapeutic mammaplasty for centrally located breast tumors.

BACKGROUND: Central breast tumors are difficult to manage using breast-conserving treatment. Mastectomy has often been cited as the favored option for these tumors, because lumpectomies that remove the nipple-areola complex often result in poor cosmesis. This article describes the use of therapeutic mammaplasty (a term used to describe breast reduction techniques utilized to treat breast cancer) for centrally sited breast tumors.
METHODS: The techniques can be broadly divided into two categories: (1) wedge excision, involving wedge excision and a form of wedge closure, and (2) advancement flaps with nipple reconstruction.
RESULTS: These techniques were used in 11 patients. Excision margins were complete in all cases except one, due to extensive ductal carcinoma in situ. There have been no other complications and no cases of recurrence to date.
CONCLUSIONS: When compared with mastectomy and total reconstruction, therapeutic mammaplasty has cosmetic, functional, and recovery time advantages. The techniques described need further evaluation and long-term follow-up. However, they can be added to the repertoire of techniques already established for breast-conserving surgery.