Francesco Marongiu1, Nicolò Bertozzi2, Andrea Sibilio3, Marco Gasperoni3, Annalisa Curcio3. 1. O.U. Breast Surgical Unit, Morgagni-Pierantoni Hospital, Ausl Romagna, Via Carlo Forlanini 34, 47100, Forli, FC, Italy. marongiufra@gmail.com. 2. Plastic and Reconstructive Surgery Unit, San Martino Hospital, Division of Plastic Surgery, Diagnostic and Surgical Sciences Department (DISC), University of Genoa, San Martino Institute for Research and Care, University of Genoa, L.go R. Benzi 10, Genoa, 16132, GE, Italy. 3. O.U. Breast Surgical Unit, Morgagni-Pierantoni Hospital, Ausl Romagna, Via Carlo Forlanini 34, 47100, Forli, FC, Italy.
Abstract
INTRODUCTION: The aim of this work was to describe our technique, the "Bifidus pedicle", which is a modification of the superomedial pedicle, for managing large breast cancers (BCs) in the upper outer quadrant (UOQ) in patients with medium/large breasts and associated ptosis. Observed complications, cosmetic outcome and oncologic safety were also reported. MATERIALS AND METHODS: Thirty patients underwent our modification of the superomedial pedicle combined with a Wise skin resection pattern for large BCs in the UOQ. All patients underwent contralateral Wise pattern breast reduction/mastopexy for symmetry. RESULTS: The average weight of the quadrantectomy specimen was 235 grams (range: 36-400 grams). Mean free tumour margin was 19.4 mm (range: 16-30). Mean operative time was 165 minutes (range: 150-220). Eight (13.2%) breasts had minor complications: two partial NAC necrosis, and six minimal wound dehiscences. Mean follow-up was 22 months (range: 12-30). Overall satisfaction rate was 91%; patients reported to be satisfied the most with the shape (92%) of the breasts, the achieved symmetry (94%), and the volume (85%), focusing on the fullness in the UOQ. CONCLUSIONS: Our Bifidus pedicle allowed to fill even wide defects in the UOQ, because we selectively employed it in patients with medium to large ptotic breasts where the lower pole had enough tissue to be displaced. Satisfactory cosmetic and oncologic outcomes were achieved with low complication rate. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
INTRODUCTION: The aim of this work was to describe our technique, the "Bifidus pedicle", which is a modification of the superomedial pedicle, for managing large breast cancers (BCs) in the upper outer quadrant (UOQ) in patients with medium/large breasts and associated ptosis. Observed complications, cosmetic outcome and oncologic safety were also reported. MATERIALS AND METHODS: Thirty patients underwent our modification of the superomedial pedicle combined with a Wise skin resection pattern for large BCs in the UOQ. All patients underwent contralateral Wise pattern breast reduction/mastopexy for symmetry. RESULTS: The average weight of the quadrantectomy specimen was 235 grams (range: 36-400 grams). Mean free tumour margin was 19.4 mm (range: 16-30). Mean operative time was 165 minutes (range: 150-220). Eight (13.2%) breasts had minor complications: two partial NACnecrosis, and six minimal wound dehiscences. Mean follow-up was 22 months (range: 12-30). Overall satisfaction rate was 91%; patients reported to be satisfied the most with the shape (92%) of the breasts, the achieved symmetry (94%), and the volume (85%), focusing on the fullness in the UOQ. CONCLUSIONS: Our Bifidus pedicle allowed to fill even wide defects in the UOQ, because we selectively employed it in patients with medium to large ptotic breasts where the lower pole had enough tissue to be displaced. Satisfactory cosmetic and oncologic outcomes were achieved with low complication rate. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Entities:
Keywords:
Breast cancer; Breast reconstruction; Breast surgery; Extreme oncoplastic surgery
Authors: Natalie D Chand; Victoria Browne; Nirmala Paramanathan; Lashan J Peiris; Siobhan A Laws; Richard M Rainsbury Journal: Plast Reconstr Surg Glob Open Date: 2017-07-24
Authors: Rieky E G Dikmans; Lauren E H Nene; Mark-Bram Bouman; Henrica C W de Vet; Marc A M Mureau; Marlon E Buncamper; Hay A H Winters; Marco J P F Ritt; Margriet G Mullender Journal: Plast Reconstr Surg Glob Open Date: 2017-03-01