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Mammographic Changes After Oncoplastic Reduction Mammoplasty

Piper, Merisa MD*; Peled, Anne Warren MD*; Price, Elissa R. MD; Foster, Robert D. MD*; Esserman, Laura J. MD, MBA; Sbitany, Hani MD*

doi: 10.1097/SAP.0000000000000484
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Background Reconstruction of partial lumpectomy defects with reduction mammoplasty techniques can improve aesthetic outcomes. However, the impact of the significant tissue rearrangement on postoperative mammographic findings and subsequent recommendations for biopsy has not been well studied.

Methods A retrospective review of 64 patients who underwent partial mastectomy with immediate oncoplastic reduction mammoplasty reconstruction from 2001 to 2008 was performed. Mammography reports at 6 months, 1 year, and 2 years postoperatively were reviewed for Breast Imaging Reporting and Data System (BI-RADS) scores, predominant findings, and recommendations for subsequent imaging or biopsy.

Results At 6 months postoperatively, 38 patients had benign findings of postsurgical changes, whereas 5 patients had benign calcifications on mammography. At 1 year, 41 patients continued to have benign mammograms, whereas 8 patients had calcifications. Five patients underwent biopsy; 4 patients revealed benign findings, and one patient revealed recurrent carcinoma. At 2 years, 50 patients had postsurgical changes, 2 patients developed fat necrosis, and 6 patients had calcifications. Two patients required biopsies, both of which demonstrated benign findings.

Overall, 89% of the patients required no additional intervention in the 2-year period after oncoplastic reduction mammoplasty. Malignancy was discovered in one patient at 1 year postoperatively, for an overall recurrence rate of 2% at 2 years.

Conclusions Although substantial tissue rearrangement is performed at the time of oncoplastic reduction mammoplasty, our results demonstrate low rates of abnormal postoperative mammograms and subsequent biopsies over the first 2 years after the procedure, supporting this technique as a safe approach to reconstructing defects after partial mastectomy.

From the *Division of Plastic & Reconstructive Surgery, Department of Surgery, †Department of Radiology, and ‡Division of Breast Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA.

Received August 19, 2014, accepted for publication, after revision, December 31, 2014.

Conflicts of interest and sources of funding: none declared.

Presented at the American Society of Plastic Surgeons Annual Meeting, San Diego, CA, 2013 and the California Society of Plastic Surgeons Annual Meeting, Newport Beach, CA, 2014.

Reprints: Hani Sbitany MD, Division of Plastic Surgery, University of California San Francisco, Suite M593, 505 Parnassus Ave, San Francisco, CA 94143. E-mail: Hani.Sbitany@ucsfmedctr.org.

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