PURPOSE

The goal of breast conservation therapy in the appropriately selected patient is complete excision of malignant tissue with minimal cosmetic deformity.  We present a technique utilizing mastopexy incisions and parenchymal rearrangement that yields excellent cosmetic results in patients with large lumpectomy defects.

METHOD

A retrospective review of 120 patients with biopsy-proven breast cancer was performed over a three year period.  All preoperative markings were placed by a single plastic surgeon, and a mastopexy pattern was chosen according to tumor location, need for skin excision and available parenchyma for reconstruction of the defect. Appropriate candidates were offered immediate symmetrizing procedures of the opposite breast.  Postoperative complications were recorded and stratified by surgical site infection, seroma formation, and positive tumor margins.

RESULTS

Between 2005 and 2008, 120 patients underwent resection of in-situ and invasive breast tumors. The overall complication rate was 5.8%.  One patient (0.8%) developed wound breakdown which was treated with local wound care.  One patient (0.8%) developed a seroma that resolved with serial aspirations.  Five patients (4.2%) had positive margins requiring reoperation.  Of these patients, four underwent subsequent mastectomy, while the remaining patient underwent re-excision.

CONCLUSION

In patients who undergo breast conservation therapy, plastic surgical techniques provide an oncologically safe method of tumor extirpation while achieving cosmetically superior results. This technique is a safe alternative to traditional lumpectomy, but requires a willingness on the part of the breast surgeon to utilize incision patterns designed by the plastic surgeon.