Double Independent Pedicle Oncoplastic Mammaplasty: A New Technique for Breast Preservation

Abstract

INTRODUCTION: This study describes a novel 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 statement. The tumors were excised with a macroscopic margin of 2 cm. The areola was kept vascularized by means of 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 (± 12.59) years. The mean tumor size was 44.25 mm (± 18.25 mm). The median preoperative ptosis was grade 2 (range: 1-3), and this 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 that they were more satisfied with breast shape after the surgery. A medial pedicle was chosen in half of the cases. Invasive ductal carcinoma was the commonest tumor. There was one benign case of pseudoangiomatous hyperplasia. One patient presented a voluminous hematoma, and evolved with partial dehiscence of the suture. There was one case of mild partial areolar necrosis. All the tumors were resected with free margins, but two patients (25.00%) underwent mastectomy and reconstruction after postoperative discovery of multicenter tumors. There was no fatty necrosis or recurrence over a 26.13-month (± 11.01) follow-up. CONCLUSIONS: The technique enabled breast conservation in unfavorable situations, with ptosis correction.