title: Dermoglandular rotation flaps for breast-conserving therapy: aesthetic results, patient satisfaction, and morbidity in comparison to standard segmentectomy.
abstract: We compared a dermoglandular rotation flap (DGR) in the upper inner, lower inner, and upper outer quadrant regarding similar aesthetic results, patient satisfaction, and comfort after breast-conserving therapy with standard segmentectomy (SE). Between 2003 and 2011, 69 patients were treated with breast-conserving surgery using DGR for cancers with high tumor-to-breast volume ratios or skin resection in the three above mentioned quadrants; 161 patients with tumors in the same quadrants were treated with SE. The outcome of the procedures was assessed at least 7 months after completed radiation therapy using a patient and breast surgeon questionnaire and the BCCT.core software. Symmetry, visibility of the scars, the position of the nipple-areola complex, and the appearance of the treated breast were each assessed on a scale from 1 to 4 by an expert panel and by the patients. Univariate and multivariate analysis were used to evaluate the relationship between patient-, tumor-, and treatment-dependent factors and patient satisfaction. 94.2% of the patients with rotation flaps and 83.5% of the patients with lumpectomy were very satisfied with the cosmetic appearance of their breast. Younger patient age was significantly associated with a lower degree of satisfaction. DGR provides good cosmetic results compared with SE and shows high patient satisfaction despite longer scarring and higher median resection volume.
authors.affiliation: Department of Obstetrics and Gynecology, Hannover Medical School, 30625 Hannover, Germany.
authors.forename: Ursula
authors.initials: U
authors.lastname: Hille-Betz
authors.affiliation: Institute of Medical Biometry and Informatics, Hannover Medical School, 30625 Hannover, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Vaske
authors.affiliation: Department of Plastic, Hand and Reconstructive Surgery, Hannover Medical School, 30625 Hannover, Germany.
authors.forename: Helga
authors.initials: H
authors.lastname: Henseler
authors.affiliation: Department of Obstetrics and Gynecology, Hannover Medical School, 30625 Hannover, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Soergel
authors.affiliation: Department of Obstetrics and Gynecology, Hannover Medical School, 30625 Hannover, Germany.
authors.forename: Sudip
authors.initials: S
authors.lastname: Kundu
authors.affiliation: Department of Obstetrics and Gynecology, Hannover Medical School, 30625 Hannover, Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Makowski
authors.affiliation: Department of Obstetrics and Gynecology, Hannover Medical School, 30625 Hannover, Germany.
authors.forename: Sophia
authors.initials: S
authors.lastname: Schelcher
authors.affiliation: Department of Obstetrics and Gynecology, Hannover Medical School, 30625 Hannover, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Wojcinski
authors.affiliation: Department of Obstetrics and Gynecology, Hannover Medical School, 30625 Hannover, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Hillemanns