BACKGROUND: Oncoplastic surgery for breast cancer (BC) may result in postoperative morbidity that can delay adjuvant treatment(s). The McKissock procedure is a reliable mammaplasty technique used in plastic surgery. The authors present their experiences in using a derived technique for the oncoplastic resection of extended malignancies located in the lower-inner (LIQ) or lower-outer (LOQ) breast quadrants. METHODS: Between 2011 and 2014, operative data of 25 patients receiving an oncoplastic resection for invasive BC or ductal carcinoma in situ (DCIS), using the modified McKissock procedure, were recorded. This technique conserved a bipedicle dermoglandular flap to improve the nipple-areola complex blood supply. Oncological and cosmetic results, as well as aesthetic outcomes and patients' satisfaction, were analyzed. RESULTS: Invasive BCs (n = 21) and DCIS (n = 4) were located in the LIQ (n = 18) or LOQ (n = 7). The median age of patients was 62 years (range 34-85), the mean resection weight was 134 g (range 43-314), and the global morbidity rate was 12 %. No nipple necrosis occurred in these patients. Free margins were obtained in 22 cases (88 %) and the secondary mastectomy rate was 8 %. Contralateral symmetrization was performed, or was required, in the majority of cases (17/23). Cosmetic results were classified as excellent or good in 93 % of patients, and the median satisfaction rate on a visual analog scale was 9.6. CONCLUSION: The modified McKissock procedure allows wide resection of cancers located in the LOQ or LIQ, and produced favorable postoperative outcomes and cosmetic results despite important resection weights.
BACKGROUND: Oncoplastic surgery for breast cancer (BC) may result in postoperative morbidity that can delay adjuvant treatment(s). The McKissock procedure is a reliable mammaplasty technique used in plastic surgery. The authors present their experiences in using a derived technique for the oncoplastic resection of extended malignancies located in the lower-inner (LIQ) or lower-outer (LOQ) breast quadrants. METHODS: Between 2011 and 2014, operative data of 25 patients receiving an oncoplastic resection for invasive BC or ductal carcinoma in situ (DCIS), using the modified McKissock procedure, were recorded. This technique conserved a bipedicle dermoglandular flap to improve the nipple-areola complex blood supply. Oncological and cosmetic results, as well as aesthetic outcomes and patients' satisfaction, were analyzed. RESULTS: Invasive BCs (n = 21) and DCIS (n = 4) were located in the LIQ (n = 18) or LOQ (n = 7). The median age of patients was 62 years (range 34-85), the mean resection weight was 134 g (range 43-314), and the global morbidity rate was 12 %. No nipple necrosis occurred in these patients. Free margins were obtained in 22 cases (88 %) and the secondary mastectomy rate was 8 %. Contralateral symmetrization was performed, or was required, in the majority of cases (17/23). Cosmetic results were classified as excellent or good in 93 % of patients, and the median satisfaction rate on a visual analog scale was 9.6. CONCLUSION: The modified McKissock procedure allows wide resection of cancers located in the LOQ or LIQ, and produced favorable postoperative outcomes and cosmetic results despite important resection weights.
Authors: Alice Lee; Richard M Kwasnicki; Hasaan Khan; Yasmin Grant; Abigail Chan; Angela E E Fanshawe; Daniel R Leff Journal: BJS Open Date: 2021-11-09