Inferior dermoglandular flap for central quadrantectomy in non-ptosis breast cancer patients

Abstract

The central located tumors has been reported to have nipple areola complex (NAC) involvement, most of the time NAC resection is also required to achieve good oncologic outcome. The tumor in this location used to be one of the indication for mastectomy. Clinical trials have proved that breast conservative surgery in centrally located tumor is similar to those who undergo mastectomy. However, in this particular situation, lumpectomy alone with simple closure may cause the deformities of the breast. This highlights the concepts of ‘immediate partial reconstruction’ during the breast conservative surgery to be able to prevent the poor cosmetic sequelae. In this study, we describe the surgical technique used in retroareolar breast cancer in non ptotic breast. The patient underwent central quadrantectomy with sentinel lymph node biopsy. Reshaping the breast by using the vertical skin pattern technique with inferior dermoglandular flap is required to fill the defect after removing central volume of the breast from breast conservative surgery (BCS). Inferior dermoglandular flap shows good outcome in non-ptotic breast with retroareolar tumor. However, a major disadvantage of our technique is the high-riding of the new NAC location. A simple and effective technique of the inferior dermoglandular flap is presented, in combination with the vertical skin pattern. This combined method allows correction of the central located tumor and parenchyma defect after BCS in all cases with acceptable results.