Breast conservation therapy, consisting of lumpectomy or segmental mastectomy with
negative margins followed by breast irradiation, has become a standard and safe alternative
to mastectomy in selected patients with early-stage breast cancer. As the inclusion
criteria for breast conservation therapy have continued to evolve to include lower
quadrant tumors, very large breasts, and central tumors, the potential for significant
disfigurement after breast conservation therapy has increased. Bilateral reduction
mammaplasty in conjunction with tumor-directed partial mastectomy is a surgical approach
that can benefit these patients by creating symmetric, aesthetically pleasing breasts
in a single-stage operation.
KEYWORDS
Breast conservation surgery - breast conservation therapy - reduction mammaplasty
REFERENCES
- 1
Losken A, Elwood E T, Styblo T M, Bostwick III J.
The role of reduction mammaplasty in reconstucting partial mastetcomy defects.
Plast Reconstr Surg.
2002;
109
968-975
- 2
Spear S L, Pelletiere C V, Wolfe A J, Tsangaris T N, Pennanen M F.
Experience with reduction mammoplasty combined with breast conservation therapy in
the treatment of breast cancer.
Plast Reconstr Surg.
2003;
111
1102-1109
- 3
Clough K B, Nos C, Salmon R J, Soussaline M, Durand J C.
Conservative treatment of breast cancers by mammaplasty and irradiation: a new approach
to lower quadrant tumors.
Plast Reconstr Surg.
1995;
96
363-370
- 4
Gray J R, McCormick B, Cox L.
Primary breast irradiation in large-breasted or heavy women: analysis of cosmetic
outcome.
Int J Radiat Oncol Biol Phys.
1991;
21
347-354
- 5
Clarke D, Martinez A, Cox R S.
Analysis of cosmetic results and complications in patients with stage I and II breast
cancer treated by biopsy and irradiation.
Int J Radiat Oncol Biol Phys.
1983;
9
1807-1813
- 6
Ray G R, Fish V J.
Biopsy and definitive radiation in stage I and II adenocarcinoma of the female breast:
analysis of cosmesis and the role of electron beam supplementation.
Int J Radiat Oncol Biol Phys.
1983;
9
813-818
- 7 Spear S L. Conservative treatment of breast cancer: reconstructive problems. In:
Surgery of the Breast: Principle and Art, Chapter 10 New York, Philadelphia; Lippincott-Raven
1998: 137-155
- 8
Zierhut D, Flentje M, Frank C, Oetzel D, Wannenmacher M.
Conservative treatment of breast cancer: modified irradiation technique for women
with large breasts.
Radiother Oncol.
1994;
31
256-261
- 9
Brierley J D, Paterson I C, Lallemand R C, Rostom A Y.
The influence of breast size on late radiation reaction following excision and radiotherapy
for early breast cancer.
Clin Oncol (R Coll Radiol).
1991;
3
6-9
- 10
Kroll S S, Schusterman M A, Reece G P, Miller M J, Smith B.
Breast reconstruction with myocutaneous flaps in previously irradiated patients.
Plast Reconstr Surg.
1994;
93
460-469
- 11
Handel N, Lewinsky B, Waisman J R.
Reduction mammaplasty following radiation therapy for breast cancer.
Plast Reconstr Surg.
1992;
89
953-955
- 12
Spear S L, Burke J B, Forman D, Zuurbier R A, Berg C D.
Experience with reduction mammaplasty following breast conservation surgery and radiation
therapy.
Plast Reconstr Surg.
1998;
102
1913-1916
- 13
Newman L A, Kuerer H M, McNeese M D et al..
Reduction mammoplasty improves breast conservation therapy in patients with macromastia.
Am J Surg.
2001;
181
215-220
- 14
Smith M L, Evans G R, Gurlek A et al..
Reduction mammaplasty: its role in breast conservation surgery for early-stage breast
cancer.
Ann Plast Surg.
1998;
41
234-239
- 15
Losken A, Elwood E T, Styblo T M, Bostwick 3rd J.
The role of reduction mammaplasty in reconstructing partial mastectomy defects.
Plast Reconstr Surg.
2002;
109
968-975
Scott L SpearM.D. F.A.C.S.
Georgetown University Hospital
3800 Reservoir Road, Washington, DC 20007