Background: Patients with a small breast volume and a relative large lumpectomy volume are at risk of developing severe breast deformity and asymmetry following breast conservation, presenting a unique surgical challenge.
Methods: A series of patients undergoing immediate reconstruction by means of an oncoplastic breast augmentation technique following breast conservation are described. The technique includes local tissue rearrangement and bilateral subpectoral breast augmentation with implants of different sizes and shapes, immediately after lumpectomy for a malignant tumor.
Results: Twenty-one consecutive patients underwent the oncoplastic breast augmentation technique (mean follow-up, 23 months; range, 12 to 48 months). Three patients (14.3 percent) had tumor-positive surgical margins. Postoperative complications included grade III/IV capsular contracture in five patients (23.8 percent) and breast infection in two patients (10 percent). All patients received postoperative radiation therapy. The cosmetic outcome was evaluated at least 6 months after radiation therapy, and it was favorable according to the reported high patient satisfaction (81 percent) and independent observers’ evaluation scores (76 percent).
Conclusions: The oncoplastic breast augmentation technique described in this article is an acceptable option in small-breasted patients with a relatively large lumpectomy volume who elect to undergo breast conservation. This technique allows conservation of the affected breast and minimizes potential breast deformation and asymmetry following radiation therapy.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
From the Department of Plastic and Reconstructive Surgery and The Center for Breast Health, Tel-Aviv Sourasky Medical Center, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University.
Received for publication February 6, 2016; accepted September 21, 2016.
Disclosure: No funding was provided for this paper. Dr. Barnea is a speaker for Johnson Medical. None of the other authors has a financial interest or personal relationship to declare in relation to the content of this article.
Yoav Barnea, M.D., Breast Reconstruction Unit, Department of Plastic and Reconstructive Surgery, Tel-Aviv Sourasky Medical Center, 6 Weizmann Street, Tel-Aviv, Israel 6423906, firstname.lastname@example.org