title: Doughnut mastopexy lumpectomy versus standard lumpectomy in breast cancer surgery: a prospective study.
abstract: OBJECTIVE
  Doughnut mastopexy lumpectomy (DML) is a unique breast resection in which a tissue segment is removed and the breast reshaped through a periareolar incision. The present prospective investigation compares DML and standard lumpectomy (SL) in relation to surgical variables, histological parameters, postoperative morbidity and cosmetic outcome.
  
  
  METHODS
  127 patients with breast cancer were offered the choice between two conservative surgical approaches: doughnut mastopexy lumpectomy (DML group, n=39) or standard lumpectomy (SL group, n=88). The groups were comparable for radiological tumour size, tumour location within the breast, histological size, and pT category. Comparison was performed in term of surgical variables, histological parameters, postoperative morbidity and cosmetic outcome.
  
  
  RESULTS
  The patients undergoing DML were younger than the patients who chose SL. In the DML group, the skin incision was 3-fold longer than in the SL group but was obtained with a final scar located around the nipple areola complex without further postoperative complications. The average volume of the breast specimen was higher in the DML group compared with SL group. The clinician assessment of cosmetic outcome reported a higher rate of acceptable result in the DML group than in the SL group. However, patient's assessment did not show difference of cosmetic satisfaction between groups.
  
  
  CONCLUSIONS
  Our comparative study indicates that DML may be a useful alternative to SL not only in terms of accurate breast tissue resection but also in term of cosmetic results.
authors.affiliation: Oncology Unit, Department of Obstetrics and Gynecology, Hôpital Arnaud de Villeneuve, 371 rue du Doyen Gaston Giraud, Herault, 34295 Montpellier Cedex 5, France. pl-giacalone@chu-montpellier.fr
authors.forename: P L
authors.initials: PL
authors.lastname: Giacalone
authors.forename: O
authors.initials: O
authors.lastname: Dubon
authors.forename: P
authors.initials: P
authors.lastname: Roger
authors.forename: N
authors.initials: N
authors.lastname: El Gareh
authors.forename: S
authors.initials: S
authors.lastname: Rihaoui
authors.forename: J P
authors.initials: JP
authors.lastname: Daurés
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D016009:Chi-Square Distribution; D004954:Esthetics; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012044:Regression Analysis; D018709:Statistics, Nonparametric; D016896:Treatment Outcome