Abstract
BackgroundHere, we describe an innovative oncoplastic technique for small to medium volume breasts with a tumor in the lower quadrant and this technique could provide sufficient tissue to avoid visible defects after tumor removal and help reshape the natural shape of the breast.MethodsA detailed procedure for the folding flap technique is described step by step. Then, the results of a retrospective analysis of patients treated using this technique, including complications and disease recurrence rate, between January 2017 and November 2021 are reported. Aesthetic outcomes were evaluated on a 5-point scale proposed by the Paris Breast Center.ResultsA total of 52 patients underwent surgery with the folding flap technique, The average operation time was 98.4 min (range, 75–120 min), and the mean bleeding volume was 56.5 mL (range, 20–100 mL). A margin-positive result was confirmed in 1 patient who underwent re-excision. Short-term postoperative complications were observed in 7 patients, including 4 with fat liquefaction, 2 with seroma, and 1 with skin redness and swelling. No flap necrosis was observed. The median follow-up time was 28.6 months (range, 9–58 months), and 2 patients experienced local recurrence. The mean aesthetic score was 4.7 points, with 36 patients scoring 5 points and 26 patients scoring 4 points, respectively.ConclusionsThe folding flap technique, as an innovative and favorable oncoplastic technique for treating small- to medium-volume breasts with a tumor in the lower quadrant, could retain sufficient tissue to fill the residual cavity after the operation while improving the aesthetic outcome of the breast.
Highlights
Breast-conserving surgery (BCS) is considered an effective treatment means to cure tumors while maintaining a relatively satisfying appearance [1]
Patients who can be considered eligible candidates for this procedure include those with small- to medium-volume breasts with a tumor located in the lower quadrant, >2 cm away from the nipple, that accounts for 20%–50% of the total breast volume
Given our experience and other research reports, in the present study, we proposed the concept of the folding flap technique
Summary
Breast-conserving surgery (BCS) is considered an effective treatment means to cure tumors while maintaining a relatively satisfying appearance [1]. Removal of a tumor located in the lower quadrant, compared to other quadrants, is more likely to result in postoperative breast deformity because, after tumor removal, the remaining glandular tissue is generally insufficient to completely fill the defect, affecting the symmetry and aesthetic appearance of the breast [3, 4] Such deformities can occur in breast cancer patients with small- to medium-volume breasts [5]. When using the volumereplacement technique, surgeons collect tissues patches from other areas of the body to replace the missing mammary gland tissue This can reshape the natural appearance of the breasts, some procedures will lead to severe postoperative complications and thereby reduce patient satisfaction [8, 9]. We describe an innovative oncoplastic technique for small to medium volume breasts with a tumor in the lower quadrant and this technique could provide sufficient tissue to avoid visible defects after tumor removal and help reshape the natural shape of the breast
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