This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Lateral mammaplasty reconstruction after surgery for breast cancer. BJS 2009; 96: 1141-1146.
Published: 28th September 2009
Authors: M. Ballester, MG. Berry, B. Couturaud, F. Reyal, R. J. Salmon, A. D. Fitoussi et al.
Background
Up to 60 per cent of cancers develop laterally in the breast and breast‐conserving surgery frequently produces superolateral nipple–areolar complex (NAC) distortion aggravated by postoperative irradiation. Correction is technically demanding and the outcomes are variable. Lateral mammaplasty may allow wider excision margins and prevent such deformities.
Method
This was a review of 86 consecutive patients who had lateral mammaplasty: combined wide tumour excision with NAC repositioning on a reliable dermoglandular pedicle. Simultaneous axillary surgery was performed via a separate or combined incision. Aesthetic outcomes were assessed.
Results
The median age of the women was 54 (range 29–75) years; 55 (64 per cent) had palpable tumours and 73 (85 per cent) underwent simultaneous axillary surgery. Median radiological and histological tumour sizes were 29·8 and 33·6 mm, respectively, and median weight of excised tumour was 150 g. Two patients required haematoma evacuation. Eleven women required revisional surgery for involved or close margins. Aesthetic outcomes were excellent or good in 93 per cent.
Conclusion
Lateral mammaplasty produced clear margins in 87 per cent of women. It is an option when a deformity is anticipated after breast‐conserving surgery, and is particularly valuable when neoadjuvant chemotherapy has downgraded a large tumour. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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