Use of different techniques of reduction mammoplasty in the total concept of oncological breast surgery

Abstract

In recent years the indication for a mastectomy for breast cancer has been increasingly restricted. The use of plastic reconstructive techniques enhances the rate of breast-conserving therapy even for large breast tumors with excellent cosmetic results and oncological safety. The breast-to-tumor ratio and locally complete resection with free tumor margins of 1–2 cm are the most important factors in breast-conserving surgery. Different techniques of reduction mammoplasty within the concept of oncological breast surgery not only allow large tumors in large breasts to be resected, but also relatively large tumors in normal sized or even smaller breasts to be resected. Other advantages are the reduction of breast size and therefore target volume before postoperative radiation procedures as well as in cancer prophylaxis and risk reduction by reducing ipsi- and contralateral breast tissue. Reduction mammoplasty techniques with different resection areas have to be selected for individual tumor locations. The best symmetry is achieved by bilateral mammoplasty in a one step procedure with lumpectomy and axillary dissection. Oncoplastic or reconstructive surgery in the target breast is often followed by procedures to improve symmetry by contralateral reduction. Whenever possible, mammoplasty techniques with minimal scarring should be chosen out of a variety of reduction procedures.