Double independent pedicle oncoplastic mammaplasty

a technique for breast preservation

Abstract

Introduction: This study describes a new means of oncoplastic mammaplasty named the double independent pedicle method. Patients and methods: Between October 2008 and August 2011, eight patients with upper-quadrant tumors of unfavorable proportions were included after signing an informed consent form. The tumors were excised with a macroscopic 2 cm margin. The areola was kept vascularized with a medial or lateral pedicle. An extensive inferocentral pedicle was constructed to fill the defect. Metal clips were emplaced to guide radiotherapy. The contralateral breast symmetry was corrected. Results: The patients’ mean age was 49.00 years (±12.59). Mean tumor size was 44.25 mm (±18.25 mm). The median preoperative ptosis was grade 2 (range: 1–3), and it was corrected in all cases. The physician’s assessment (from 0 to 10) for breast shape and symmetry was 9.13 (±1.46). All the patients said they were more satisfied with breast shape after surgery. A medial pedicle was chosen in 50% of the cases. Invasive ductal carcinoma was the most common tumor. There was one benign case of pseudoangiomatous hyperplasia. One patient presented a voluminous hematoma, which evolved with partial dehiscence of the suture. There was one case of mild partial areola necrosis. All tumors were resected with free margins, but two patients (25%) underwent mastectomy and reconstruction after the postoperative discovery of multicenter tumors. There was no fat necrosis or recurrence over a period of 26.13 (±11.01) months of follow-up. Conclusions: The technique enabled breast conservation in unfavorable situations, with ptosis correction.