Periareolar zigzag incision in breast conserving surgery.

Abstract

e12093 Background: Breast conserving surgery (BCS) followed by radiation therapy is today standard therapy for early breast cancer. Avoiding scars on the breast is women’s desire. Numerous minimal approaches have evolved due to this concern. The periareolar incision is often used to remove relatively small tumors located near the nipple. But periareolar incision has a disadvantages include limited exposure of the surgical field. Periareolar zigzag incision has the advantage of not only good surgical field but also contributed to better surgical scars. The purpose of this study was to evaluate the usefulness of periaroar zigzag incision and oncological safety. Methods: We retrospectively reviewed breast cancer patients who performed breast conserving surgery with periareolar zigzag incision by one surgeon from January 2016 to December 2016. In this study, patients with bilateral breast cancer or other diseases who underwent cooperative surgery were excluded. Intraoperative frozen section margin was evaluated in all patients and additional resection was performed when positive margin was present. Final margin status was determined by examination of the permanent paraffin-embedded sections. Patients characteristics, tumor characteristics, operative time, size of specimen and the distance from the tumor to nipple were evaluated. Results: A total of 193 patients were reviewed. The median age of the patients was 50 years (range: 25-79 years), median tumor size was 1.7 cm (range: 0-8.8 cm), median tumor distance from the nipple was 3.0 cm (range: 0.5-8.0 cm) and median specimen sized was 5.0 cm (range: 2.0-15.0 cm). The median operation time was 70 minutes (range: 32-138 min) in patients without axillary dissection, and 91 minutes (range: 60-171 min) in patients who underwent axillary dissection. In 13 patients (6.7%), tumor was found in intraoperative frozen biopsy and re-excision was performed. There were no major complications associated with surgery. There were no reoperations due to bleeding or other reasons. Conclusions: In breast conservation surgery, the periareolar zigzag incision technique has good cosmetic effect and a enough operative field can be obtained, so it may be applied oncological safely even when relatively large tumors are removed.