ONCOPLASTIC TECHNIQUES FOR EARLY UPPER INNER QUADRANT BREAST CANCER; A COMPARATIVE STUDY BETWEEN INFERIOR PEDICLE MAMMAPLASTY AND DOUGHNUT MASTOPEXY

Background: Breast conserving treatment (BCT) has become the standard treatment in early breast cancer; its goal is to provide a treatment as effective as mastectomy with the added benefit of a preserved breast. However, it is sometimes difficult to achieve good cosmetic results, particularly in patients with breast cancer located in the upper inner quadrant, for which the traditional conservative surgery results in a deformed breast. Aim of the work: To compare prospectively the oncoplastic results of inferior pedicle mammaplasty and doughnut mastopexy as techniques for early breast cancers located at the upper inner quadrant. Patients and Methods: This is a prospective randomized study on twenty female patients who were diagnosed to have early breast cancer located in the upper inner quadrant and are candidates for
oncoplastic breast surgery. The study was conducted at Ain Shams University Hospitals. Approval of the Ethical Committee and written informed consent from all participants were obtained. Patient selection was achieved through a number of inclusion and exclusion criteria. Results: There is significant difference between the two groups as regards the operative time, intraoperative blood loss, hospital stay, total drainage volume, drainage days, postoperative complications,
cosmetic outcome and the need for contralateral symmetrization. Inferior pedicle mammaplasty needs longer operative time and postoperative hospital stay and drainagy days with more intraoperative blood loss in comparison to Doughnut mastopexy. As regards the postoperative complications, we found that there are more complications in Inferior pedicle mammaplasty than Doughnut mastopexy as wound wound infection and dehiscence. Conclusion: Patients with early breast cancer located in the upper inner quadrant are candidate for either Inferior pedicle mammaplasty or Doughnut mastopexy. Doughnut mastopexy is better for them as there is less morbidity, better cosmesis, no need for contralateral symmetrization and fewer complications, so no delay in radiotherapy and Inferior pedicle mammaplasty needs more surgeon experience.