title: Can saline be an alternative to aesthetic surgery in extended breast quadrantectomy?
abstract: OBJECTIVE
  To explore other simpler options sparing the patients the morbidity and cost in extended breast quadrantectomy.
  
  
  METHODS
  This prospective study was undertaken at King Fahd Hospital of the University, Al-Khobar, Eastern Province of Saudi Arabia between 1999-2005. Factors considered for patients undergoing breast-conserving surgery were based on age, tumor size, pathological characteristics, and patient's preference. Frozen section was adopted in all procedures to insure negative margins. After extended quadrantectomy, 200-400 cc was injected into the cavity to retain breast contour. Magnetic resonance imaging was used for postoperative assessment.
  
  
  RESULTS
  Twenty-four patients were included, aged 28-43 years and tumor size 3-5 cms. All margins were negative on frozen section. The contour of the breast was restored with saline, MRI was employed for follow up at the immediate post operative period and at 4-6 months, it demonstrated restored breast contour and the saline filled cavity replaced by lipo-fibrous tissue. Follow up after 4-24 months showed that all patients noticed some degree of asymmetry, yet were satisfied with the result, none required or requested additional surgery.
  
  
  CONCLUSIONS
  In large tissue excisions injecting saline into cavities temporarily prevents the caving in of the redundant skin, which has the tendency to permanently adhere to the fascia thereby preventing gross deformities. It has proven effective, contour storing and scored high satisfaction among patients. It certainly does not replace cosmetic breast surgery, however, it should be considered in centers were onco-plastic surgery is not readily available.
authors.affiliation: Department of Surgery, King Fahd Hospital of the University, Al-Khobar, Kingdom of Saudi Arabia.. abdelhadi_m@hotmail.com
authors.forename: Maha S A
authors.initials: MS
authors.lastname: Abdel Hadi
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D017046:Cost Savings; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D016462:Mammaplasty / Q000379:methods*; D015412:Mastectomy, Segmental / Q000009:adverse effects / Q000379:methods*; D017060:Patient Satisfaction; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D012307:Risk Factors; D012965:Sodium Chloride / Q000008:administration & dosage* / Q000191:economics; D016896:Treatment Outcome
chemical_list: D012965:Sodium Chloride