A Universal Level Ii Oncoplastic Surgery Technique in a Difficult Situation Publisher



Zavieh MM¹ ; Raei N¹ ; Kaviani A² Show Affiliations
Source: Iranian Journal of Breast Diseases Published:2022

Abstract

Introduction: Oncoplastic breast surgery (OBS) was introduced over 25 years ago with the integration of plastic surgery and breast cancer surgery. It follows two goals. The first one is the improvement of disease outcomes and local control, and the second one is the improvement of the quality of life. In some situations, oncoplastic breast surgery faces challenges, such as large tumors, skin involvements, and certain tumor locations, like the inner or central parts. In this paper, we aim to describe how to adopt a previously known reduction mammaplasty technique to be used as a universal level II OBS technique in complex situations. Methods: The technique starts with a classic incision of reduction mammoplasty. The skin flaps are made liberally over the tumor and can be extended to most parts of the breast except for the central part. The thickness of the flap is considered identical to the mastectomy flap to provide the safest oncologic operation. After the skin flap preparation over the tumor site and tumor resection with respect to the vessels central posterior to the nipple, rotational pedicles of breast tissue fill the tumor site, and the skin is closed as in a routine mammoplasty. Conclusion: Although this technique can be used in most complex situations, the best indication is in patients whose breasts are significantly ptotic and who have the desire to rectify it and make the contralateral breast symmetric. The importance of this technique would be clearer when routine mammoplasty techniques (superomedial pedicle and inferior pedicle) cannot be adopted because of insufficient tissue to fill up the resection cavity or the risk of compromising the vascular pedicles. © 2022 Elsevier Masson SAS. All rights reserved.