TITLE:
Therapeutic Mammoplasty in Management of Breast Cancer: A Prospective Clinical Study
AUTHORS:
Ahmed Mohamed Farahat, Amr Abdel Meguid Attia, Mohamed Aly M. El Shafei El Zawahry, Mohamed H. Zedan, Hussein Osama Soliman
KEYWORDS:
Breast Oncoplasty, Therapeutic Mammoplasty, Surgery, Oncology, Plastic, Symmetry
JOURNAL NAME:
Advances in Breast Cancer Research,
Vol.6 No.4,
September
20,
2017
ABSTRACT: Background: The introduction of oncoplasticbreast surgery, with
a concomitant contralateral symmetrization procedure, allows the surgical
oncologist the freedom to perform wider excisions, with more favorable cosmetic
outcomes. Objective: To assess the feasibility of bilateral breast
reduction for the management of breast cancer, and to determine the most
suitable surgical technique of therapeutic mammoplasty for each patient. And to
evaluate the cosmetic outcome during the postoperative period. Methods: This
study was from June 2014 until June 2016, and included 86 female patients with
breast cancer; divided in 3 groups; group A; had bilateral superior pedicle
reduction mammoplasty, group B; had bilateral inferior pedicle reduction
mammoplasty, group C; had bilateral batwing mastopexy. 1 month postoperative,
patients were asked to answer a 5-scale questionnaire evaluating their own
cosmetic outcome. Criteria they were asked to evaluate were: symmetry, shape and volume, projection, correction
of ptosis, visibility of the scars and overall satisfaction. A similar
questionnaire was answered by a panel made up of a surgeon and breast-care
nurse after seeing the pre- and post-operative photos of the patients in
question. Results: Group A had a mean tumor size of 2.7 ± 0.69 cm, least resected margins 1.2 - 4.3 cm, Group B had a mean tumor size of 3.2 ± 1.19 cm,
least resected margins 0.7 - 3.8 cm, Group C had a mean tumor
size of 3.4 ± 1.12 cm, least resected margins 1.7 - 5.2 cm. Cosmetic results fared high above average. Group
C fared better in overall satisfaction but Group B fared better in ptosis
correction, projection and symmetry. The panel answers showed difference regarding
shape and volume; the only two criteria to be almost of the same result among
the three groups. Conclusion: Bilateral TM has some
advantages when compared to standard conventional BCS techniques without having
any unfavorable effects on surgical margin confidence, local recurrence, and
survival rates. So, it is a valuable addition to consider the use of such
surgical techniques whenever indicated in the surgical management of patients
with breast cancer. Batwing mastopexy showed superiority in operating time,
hospital stay and overall satisfaction of patients, surgeons and nurses.