A Retrospective Analysis of Patient Satisfaction with Reduction Mammaplasty After Conservative Surgery for Breast Cancer

Background: Breast-conserving surgery is widely accepted as the treatment of choice in properly selected patients with early breast cancer. Among the immediate reconstruction techniques, the reduction mammaplasty remains a useful procedure according to the initial breast volume, ptosis and the amount of glandular tissue resected. It has aesthetic, functional and oncologic advantages, leading to high satisfaction and improvement in quality of life of the patients.

Methods: The authors performed a retrospective review of patients who underwent immediate reduction mammaplasty after breast conservative surgery, in a three-year period (2008-2010). The technique of reduction, radiation, complications, and cancer recurrence/occurrence were analyzed. Patients reported their level of satisfaction in a 0-10 scale and willingness to undergo the procedure again (Yes or No options).

Results: A total of 27 patients submitted to breast-conserving surgery and reduction mammaplasty were included in this study. The supero-medial pedicle technique used in 11 reductions (11%),  like the inferior pedicle technique (11%), were the most utilized techniques. Reconstruction with Thorek technique was used in two cases and supero-lateral technique in three. All the majority of patients (24 patients-88,9%) underwent postoperative radiotherapy;  There was a total complication rate of 25,9% with an overall major complication rate of 7,4% concerning to an hematoma and breast infection requiring re-intervention; minor complications  were seen in six patients (22,2%). Two patients underwent mastectomy in order to the pathologic findings of cancer persistence.  When asking the patients if they would repeat the breast reconstruction if necessary, twenty-five (92,6%) said “Yes” and just one said she wouldn’t repeat; one patients couldn’t be contacted. In a 0-10 scale questionnaire of level of satisfaction, 84,6% (22 patients) attributed a value equal or superior to 8; mean of 8,4, minimum of 1 (1 patient), corresponding to a patient probably with little motivation/high or unrealistic expectations; maximum value of 10.

Conclusions:  Reduction mammaplasty is a reliable technique and should be considered in breast-conserving reconstruction. In the population analized the level of satisfaction was high and the major complication rate was low, making this technique an option for  well selected patients.