Evaluation of Central Quadrentectomy and Immediate Reconstruction in Patients with Retroareolar Breast Cancer

Abstract

Abstract Background Centrally located breast cancer represents 5–20 % of all breast cancer cases. Oncoplastic breast surgery combines oncological principles with plastic surgical techniques; it requires knowledge of anatomy, and appreciation of symmetry, esthetics and breast function. Aim of the Work The aim of the current study is to present and assess multiple techniques of surgical outcome of oncoplastic techniques following the resection of centrally located breast cancer. Patients and Methods This prospective study comprised of 24 female patients with central breast cancer from November 2018 to Feb 2020 at the department of surgery Ain-Shams University Hospitals. Patients were followed up every 3 months for at least 12 months. Informed consent was obtained from the patients, and this study was approved by Al.Demerdash Hospital ethics committee. Results In our study, statistics shows to some extent, When NAC is not involved Flierl and Hanker [11] reported satisfactory results with central quadrentectomy and immediate reconstruction in patients with retroareolar breast cancer. The mean age was 49.83 ± 7.6 years (range; 39 to 60). 13/24 patients (54.16%) were premenopausal while 11/24 (45.83%) patients were postmenopausal. 5 patients had diabetes mellitus and the rest of patients were non diabetic. Four patients (16.6%) had positive family history of breast cancer. Six patients had nipple retraction (25%). The mean tumour size was 2.52 ± 0.64 cm cm (0.9-2.8 cm). The spectrum of safety margin ranged from (1.9-2.8 cm) the mean safety margin in our study is 2.19±0.32, The overall percentage of complications was 5/24 (20.8%). Pathological nipple infiltration was found in 12 cases (50%) showed clinical and/or radiological evidence of nipple involvement and underwent resection of the NAC (Grissoti and Melon slice techniques). 14 patients (58.33%) had positive axillary lymph nodes, all staged as pN1; while the other 10 patients (41.66%) where staged as pN0. There is significant statistical difference between the two groups; Patient dissatisfaction is due to presence of scar, breast shape asymmetry and absence of NAC as in Grisotti and Melon slice groups or asymmetry as in Inferior pedicle group. Conclusion Multiple oncoplastic breast surgery techniques used in treatment of CLBC with good cosmetic and oncological outcome but need more training to have good results.