Oncoplastic Reduction Mammoplasty: Incision Patterns, Safety Issues, and Plasticity

Abstract

Macromastia has been considered a contraindication to breast conservation therapy because of difficulties with radiation therapy. Bilateral reduction mammoplasty in conjunction with a tumor-directed and segmental oriented partial mastectomy is a surgical technique that can potentially improve the efficacy of radiation therapy in this setting, alleviate the neuropathic symptoms that can accompany macromastia, and increase rates of breast-preserving surgery for breast cancer patients. Many different and varied techniques for breast reduction have been described. In addition, many of these procedures have variably overlapping technical details, all of which can create confusion when attempting to evaluate published results. To achieve the aims and quality indicators of breast conservation therapy in conjunction with aesthetic results, a reduction technique with a modified inferior flap and superior pedicle was developed. This technique can be used as a standardized oncoplastic procedure in breast conservation therapy associated with macromastia and in aesthetic surgical treatment of macromastia, ptosis, and tubular breasts. The principles of the tumor-adapted reduction mammoplasty developed are described.