Therapeutic Mammoplasty in Management of Breast Cancer: A Prospective Clinical Study

Background: The introduction of oncoplasticbreast surgery, with a concomitant contralateral symmetrization procedure, allows the surgical oncologist the freedom to perform wider excisions, with more favorable cosmetic outcomes. Objective: To assess the feasibility of bilateral breast reduction for the management of breast cancer, and to determine the most suitable surgical technique of therapeutic mammoplasty for each patient. And to evaluate the cosmetic outcome during the postoperative period. Methods: This study was from June 2014 until June 2016, and included 86 female patients with breast cancer; divided in 3 groups; group A; had bilateral superior pedicle reduction mammoplasty, group B; had bilateral inferior pedicle reduction mammoplasty, group C; had bilateral batwing mastopexy. 1 month postoperative, patients were asked to answer a 5-scale questionnaire evaluating their own cosmetic outcome. Criteria they were asked to evaluate were: symmetry, shape and volume, projection, correction of ptosis, visibility of the scars and overall satisfaction. A similar questionnaire was answered by a panel made up of a surgeon and breast-care nurse after seeing the pre- and post-operative photos of the patients in question. Results: Group A had a mean tumor size of 2.7 ± 0.69 cm, least resected margins 1.2 - 4.3 cm, Group B had a mean tumor size of 3.2 ± 1.19 cm, least resected margins 0.7 - 3.8 cm, Group C had a mean tumor size of 3.4 ± 1.12 cm, least resected margins 1.7 - 5.2 cm. Cosmetic results fared high above average. Group C fared better in overall satisfaction but Group B fared better in ptosis correction, projection and symmetry. The panel answers showed difference regarding shape and volume; the only two criteria to be almost of the same result among the three groups. Conclusion: Bilateral TM has some advantages when compared to standard conventional BCS techniques without having any unfavorable effects on surgical margin confidence, local recurrence, and survival rates. So, it is a valuable addition to consider the use of such surgical techniques whenever indicated in the surgical management of patients with breast cancer. Batwing mastopexy showed superiority in operating time, hospital stay and overall satisfaction of patients, surgeons and nurses.