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The Impact of Partial Breast Reconstruction Using Reduction Techniques on Postoperative Cancer Surveillance

Losken, Albert M.D.; Schaefer, Timothy G. M.D.; Newell, Mary M.D.; Styblo, Toncred M. M.D.

Plastic & Reconstructive Surgery: July 2009 - Volume 124 - Issue 1 - pp 9-17
doi: 10.1097/PRS.0b013e3181ab10e5
Breast: Original Articles

Background: Partial breast reconstruction using reduction techniques has recently increased in popularity. Some fear that combining breast conservation therapy with partial breast reconstruction alters the architecture and will affect patterns of local recurrence and make postoperative cancer surveillance more difficult. The purpose of this series was to evaluate long-term postoperative cancer surveillance.

Methods: The authors retrospectively reviewed the charts and mammograms of patients (n = 17; average follow-up, 6.3 years) who underwent the oncoplastic reduction technique before 2004. Mammography sensitivity was determined by measuring breast density, qualitative changes, and time until mammographic stabilization was determined. These data were compared with those of a control group from the same time period who underwent breast conservation therapy alone (n = 17; average follow-up, 5.9 years).

Results: Typical mammographic findings, including architectural distortion, cysts, and calcifications, were similar between the two groups. There was no significant difference in breast density scores. The oncoplastic reduction group had longer times to mammographic stabilization (21.2 versus 25.6 months, p = 0.23). There was a trend toward a greater number of postoperative mammograms and ultrasounds in the study group when indexed per follow-up year. The rate of tissue sampling in the study group was significantly higher (53 percent) than that in the control group (18 percent).

Conclusions: The oncoplastic reduction technique remains safe and effective, without significantly affecting postoperative surveillance. Mammographic findings were similar to those observed in patients with breast conservation therapy alone, and sensitivity was not affected. It takes longer to achieve mammographic stability and more patients in the oncoplastic group will require additional diagnostic testing.

Atlanta Ga.

From the Emory Division of Plastic and Reconstructive Surgery, Division of Surgical Oncology, and Department of Radiology, Emory University School of Medicine.

Received for publication August 12, 2008; accepted November 7, 2008.

Disclosure: The authors have no commercial associations or financial disclosures that might pose or create a conflict of interest with information presented in this article.

Albert Losken, M.D., Emory Division of Plastic Surgery, 550 Peachtree Street, Suite 84300, Atlanta, Ga. 30308, albert_losken@emoryhealthcare.org

©2009American Society of Plastic Surgeons