by Deigni, Olivier A.; Baumann, Donald P.; Adamson, Karri
A.; Garvey, Patrick B.; Selber, Jesse C.; Caudle, Abigail S.; Smith, Benjamin
D.; Hanson, Summer E.; Robb, Geoffrey L.; Schaverien, Mark V.
Plastic and
Reconstructive Surgery: May 2020 -
Volume 145 - Issue 5 - p 1134-1142
Background:
Oncoplastic breast-conserving surgery expands the indications for breast
conservation. When performed using modified mastopexy/breast reduction
techniques, the optimal timing of the contralateral symmetrizing
mastopexy/breast reduction remains unclear. This study examined the effect of
the timing of symmetrizing mastopexy/breast reduction on oncoplastic
breast-conserving surgery outcomes.
Methods: A
retrospective study was conducted of all patients who underwent oncoplastic
breast-conserving surgery using mastopexy/breast reduction techniques at a
single center from 2010 to 2016. Patients who received synchronous (immediate)
contralateral breast symmetrizing mastopexy were compared with those who
underwent a delayed symmetrizing mastopexy procedure. Demographic, treatment,
and outcome data were collected. Descriptive statistics were used and
multivariate analysis was performed to evaluate the various relationships.
Results: There
were 429 patients (713 breasts) included in the study; of these, 284 patients
(568 breasts) underwent oncoplastic breast-conserving surgery involving
mastopexy/breast reduction techniques and immediate symmetrizing mastopexy, and
145 patients underwent delayed contralateral symmetrizing mastopexy. The
overall complication rate was similar between the immediate and delayed groups
(25.4 percent versus 26.9 percent, respectively; p = 0.82), as was the major
complication rate (10.6 percent versus 6.2 percent; p = 0.16). Complications
resulted in a delay in adjuvant therapy in 18 patients (4.2 percent); in two
patients (0.7 percent), this delay resulted from a complication in the
contralateral symmetrizing mastopexy breast. Immediate contralateral
symmetrizing mastopexy was not associated with increased risk of complications
per breast (p = 0.82) or delay to adjuvant therapy (p = 0.6).
Conclusion:
Contralateral mastopexy/breast reduction for symmetry can be performed at the
time of oncoplastic breast-conserving surgery in carefully selected patients
without significantly increasing the risk of complications or delay to adjuvant
radiation therapy. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
