title: Therapeutic mammaplasty--analysis of 50 consecutive cases.
abstract: This is a descriptive analysis of 50 consecutive cases of therapeutic mammaplasty, the use of reduction mammaplasty and radiotherapy to treat breast tumours. Breast cancers may lie within the normal excision site of a recognised mammaplasty method (scenario A) or outside of the expected excision sites (scenario B), then requiring a modified mammaplasty. A third group are central tumours requiring removal of the nipple. This series includes 13 scenario A, 27 scenario B and 10 central tumours. Wise pattern skin incision was used in 29 (58%) and vertical in 14 (28%). Seven different pedicles were employed but inferior (11), superior (9) and superio-medial (19) comprised the majority (78%). In the 27 scenario B cases an extension of the nipple aereolar pedicle was used to fill the tumour defect in 19 (70%) and a secondary pedicle in 8 (30%). There were no incomplete excisions of invasive tumour but incomplete excision of DCIS requiring mastectomy occurred in 4 (8%) patients. There are no deaths or recurrences to date (mean follow-up 13 months, range 3-32). Complications have occurred in 8 (16%) with a return to theatre for one complication (2%) and the four patients (8%) requiring mastectomy. No patient has had a delay in adjuvant treatment. Cosmetic outcome was deemed good/excellent in 63%, satisfactory in 33%, poor in 4%. Follow-up is restricted to 3-32 months.
authors.affiliation: Breast Reconstruction Service, Department of Plastic Surgery, Nottingham City Hospital, UK. smcculle@ncht.trent.nhs.uk
authors.forename: S J
authors.initials: SJ
authors.lastname: McCulley
authors.forename: R D
authors.initials: RD
authors.lastname: Macmillan
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D018365:Neoplasm, Residual; D009558:Nipples / Q000601:surgery; D018714:Radiotherapy, Adjuvant; D012008:Recurrence; D016896:Treatment Outcome