Oncoplastic Surgery: Central Quadrant Techniques
Breast-conserving therapy offers both effective treatment and the psychological benefit of retention of the breast. For breast conservation to be effective, the primary tumor must be resected with adequate surgical margins while simultaneously maintaining the breast’s shape and appearance. Declivity of the skin and/or displacement of the nipple-areolar complex (NAC) can occur when the target lesion is sizable and can create especially troubling defects for centrally located lesions. Some type of central closure of the breast is commonly required when larger areas of breast tissue are removed. The use of “volume-displacement” techniques for advancing fibroglandular tissue sections along the chest wall to close large resection cavities has become a fundamental tool for cosmetically optimized breast conservation surgery. The techniques described in this chapter include those used for central segmental resections that utilize volume-displacement techniques in which local parenchymal tissue flaps are advanced for glandular remodeling and include the central lumpectomy, batwing mastopexy lumpectomy, donut mastopexy lumpectomy, and variations on the reduction mastopexy lumpectomy which utilize a pedicle flap to restore the nipple-areolar complex.
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