title: Bilateral reduction mammoplasty in combination with lumpectomy for treatment of breast cancer in patients with macromastia.
abstract: BACKGROUND
  Bilateral reduction mammoplasty has been described as a surgical option for treatment of breast cancer in women with large, pendulous breasts. Using this technique can provide unique surgical oncologic challenges.
  
  
  METHODS
  Retrospective chart review.
  
  
  RESULTS
  Thirty-seven patients were identified. The average weight of tissue removed was 653 g. Tumor size ranged from 0.6 to 5.2 cm. One patient had microscopically positive surgical margins on final pathology. The tumor bed was not marked, and completion mastectomy was required. Two patients had unexpected malignancy in the contralateral breast. One patient required completion mastectomy for positive nonoriented margins. In another patient, tissue from the contralateral side was oriented, and mastectomy was avoided.
  
  
  CONCLUSIONS
  Bilateral reduction mammoplasty with lumpectomy is an ideal option in women with macromastia. We recommend marking the tumor bed on the flaps and pedicle as well as orienting tissue removed from the contralateral side as maneuvers that will decrease need for completion mastectomy.
authors.affiliation: Oregon Health and Science University, Portland, OR, USA.
authors.forename: Eugene
authors.initials: E
authors.lastname: Chang
authors.forename: Nathalie
authors.initials: N
authors.lastname: Johnson
authors.forename: Bruce
authors.initials: B
authors.lastname: Webber
authors.forename: James
authors.initials: J
authors.lastname: Booth
authors.forename: Dina
authors.initials: D
authors.lastname: Rahhal
authors.forename: David
authors.initials: D
authors.lastname: Gannett
authors.forename: William
authors.initials: W
authors.lastname: Johnson
authors.forename: Daisy
authors.initials: D
authors.lastname: Franzini
authors.forename: Henry
authors.initials: H
authors.lastname: Zegzula
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000150:complications / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D001940:Breast; D001943:Breast Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D002278:Carcinoma in Situ / Q000150:complications / Q000473:pathology / Q000601:surgery; D044584:Carcinoma, Ductal / Q000150:complications / Q000473:pathology / Q000601:surgery; D018275:Carcinoma, Lobular / Q000150:complications / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D006984:Hypertrophy; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D015412:Mastectomy, Segmental / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D018579:Patient Selection; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D021701:Sentinel Lymph Node Biopsy / Q000379:methods; D013524:Surgical Flaps; D016896:Treatment Outcome