Therapeutic reduction mammoplasty in large-breasted women with cancer using superior and superomedial pedicles

Adel Denewer,¹ Fayez Shahatto,¹ Waleed Elnahas,¹ Omar Farouk,¹ Sameh Roshdy,¹ Ashraf Khater,¹ Osama Hussein,¹ Saleh Teima,² Mohammed Hafez,¹ Samir Zidan,¹ Nazem Shams,¹ Sherif Kotb<sup>1

1</sup>Surgical Oncology Department, Oncology Center, ²Clinical Oncology and Nuclear Medicine Department, Mansoura University, Mansoura, Egypt

Background: Surgical management of breast cancer in large-breasted women presents a real challenge. This study aims to evaluate the outcome of therapeutic reduction mammoplasty in large-breasted women with breast cancer using superior and superomedial pedicles, situated at any breast quadrant except for the central and upper medial quadrants.
Methods: Fifty women with breast cancer and large breasts underwent simultaneous bilateral reduction mammoplasty. The weight of the tissue removed ranged from 550 g to 1050 g and the tumor-free safety margins by frozen section were in the range of 4 cm to 12 cm.
Results: The age of the patients ranged from 36 to 58 (median 43) years and tumor size ranged from 1 cm to 4 cm. The cosmetic outcomes were excellent in 32 patients (64%), good in 15 (30%) patients, and fair in three patients (6%). The follow-up period was 8–36 (mean 20) months, with no local recurrence or systemic metastasis.
Conclusion: Therapeutic reduction mammoplasty using superior and superomedial pedicles was shown to be oncologically safer than traditional conservative surgery. This oncoplastic procedure yields a satisfactory esthetic outcome with lower morbidity in large-breasted women with breast cancer.

Keywords: breast cancer, oncoplastic surgery, reduction mammoplasty, conservation surgery