title: A Simple and Effective Technique of Breast Remodelling After Conserving Surgery for Lower Quadrants Breast Cancer.
abstract: BACKGROUND
  Quadrantectomy is an oncologically safe procedure for the treatment of early-stage breast cancer, but it often results in poor aesthetic outcomes such as breast shape deformity, which is more visible if the tumour is located in the lower pole. We recommend the use of the transverse incision, which retains the oncological advantages of the quadrantectomy while leading to better aesthetical results.
  
  
  METHODS
  We evaluated the clinical results of 24 patients with breast cancer who underwent quadrantectomy of the lower breast pole and volume replacement with remodelling through three posterior scorings from January 2012 to January 2014, with cosmetic evaluations performed according to the criteria set by the Japanese Breast Cancer Society.
  
  
  RESULTS
  Minimum follow-up after surgery was 2 years, with an average of 28.4 months. Among treated patients, the percentage of complications was extremely low and the degree of satisfaction fairly good. Moreover, the assessment of the medical team matched patient self-assessments.
  
  
  CONCLUSIONS
  Immediate breast reconstruction of a defect performed after a quadrantectomy of the lower breast pole using the "posterior scoring technique" provided better cosmetic results compared to the transposition of residual breast tissue. This technique provides reliable and reproducible results, and it also appears to be rather successful on patients with small-moderate breasts in the absence of a certain degree of ptosis, therefore increasing its already considerable appeal.
  
  
  METHODS
  This journal requires that the authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
authors.affiliation: Breast Unit, Department of Plastic and Reconstructive Surgery, University of Udine, c/o Ospedale "S. Maria della Misericordia", piazzale santa maria della misericordia 15, 33100, Udine, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: De Biasio
authors.affiliation: Breast Unit, Department of Plastic and Reconstructive Surgery, University of Udine, c/o Ospedale "S. Maria della Misericordia", piazzale santa maria della misericordia 15, 33100, Udine, Italy. zingarettin@gmail.com.
authors.forename: Nicola
authors.identifier: http://orcid.org/0000-0002-1575-0029
authors.initials: N
authors.lastname: Zingaretti
authors.affiliation: Plastic Surgery Department, IRCCS Policlinico San Donato, University of Milan, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Marchesi
authors.affiliation: Plastic Surgery Department, IRCCS Policlinico San Donato, University of Milan, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Vaienti
authors.affiliation: Breast Unit, Department of Plastic and Reconstructive Surgery, University of Udine, c/o Ospedale "S. Maria della Misericordia", piazzale santa maria della misericordia 15, 33100, Udine, Italy.
authors.forename: Daria
authors.initials: D
authors.lastname: Almesberger
authors.affiliation: Breast Unit, Department of Plastic and Reconstructive Surgery, University of Udine, c/o Ospedale "S. Maria della Misericordia", piazzale santa maria della misericordia 15, 33100, Udine, Italy.
authors.forename: Pier Camillo
authors.initials: PC
authors.lastname: Parodi
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000601:surgery; D015331:Cohort Studies; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D015412:Mastectomy, Segmental / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D013524:Surgical Flaps / Q000098:blood supply / Q000637:transplantation*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
keywords: Breast reconstruction; Breast-conserving surgery; Cosmetic evaluation; Posterior scoring technique