Superior Pedicle Techniques

Abstract

Breast conservation therapy (BCT) for cancer is considered to be as safe as mastectomy in early-stage breast cancer. However, poor cosmetic outcomes of BCT are more frequent in hypertrophic and/or ptotic breasts than in small breasts. Techniques of breast reduction coupled with BCT, oncoplastic surgery, help to improve this aesthetic result. The superior pedicle breast reduction technique is useful for the treatment of tumor of the inferior quadrant of the breast from the 3 o’clock to the 9 o’clock position. Small tumors (T1, T2) are well treated by BCT, but indications are now extended to larger tumors when the breast size allows larger resection. Oncoplastic surgery with the superior pedicle breast reduction technique is suitable for large breasts (cup size D or greater). The type of the tumor (ductal carcinoma in situ, lobular invasive, multicentric, vascular invasion) and the age of the patient (below 40 years) can raise the positive margin and recurrence rates; therefore, specific evaluation is necessary in these cases. Oncoplastic surgery is generally discouraged in already irradiated breasts. The long-term oncologic results of BCT with oncoplastic surgery are comparable with the results of BCT randomized trials.