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. 2014:2014:152451.
doi: 10.1155/2014/152451. Epub 2014 Nov 4.

Dermoglandular rotation flaps for breast-conserving therapy: aesthetic results, patient satisfaction, and morbidity in comparison to standard segmentectomy

Ursula Hille-Betz  1 , Bernhard Vaske  2 , Helga Henseler  3 , Philipp Soergel  1 , Sudip Kundu  1 , Lars Makowski  1 , Sophia Schelcher  1 , Sebastian Wojcinski  1 , Peter Hillemanns  1
Affiliations

Dermoglandular rotation flaps for breast-conserving therapy: aesthetic results, patient satisfaction, and morbidity in comparison to standard segmentectomy

Ursula Hille-Betz et al. Int J Breast Cancer. 2014.

Abstract

We compared a dermoglandular rotation flap (DGR) in the upper inner, lower inner, and upper outer quadrant regarding similar aesthetic results, patient satisfaction, and comfort after breast-conserving therapy with standard segmentectomy (SE). Between 2003 and 2011, 69 patients were treated with breast-conserving surgery using DGR for cancers with high tumor-to-breast volume ratios or skin resection in the three above mentioned quadrants; 161 patients with tumors in the same quadrants were treated with SE. The outcome of the procedures was assessed at least 7 months after completed radiation therapy using a patient and breast surgeon questionnaire and the BCCT.core software. Symmetry, visibility of the scars, the position of the nipple-areola complex, and the appearance of the treated breast were each assessed on a scale from 1 to 4 by an expert panel and by the patients. Univariate and multivariate analysis were used to evaluate the relationship between patient-, tumor-, and treatment-dependent factors and patient satisfaction. 94.2% of the patients with rotation flaps and 83.5% of the patients with lumpectomy were very satisfied with the cosmetic appearance of their breast. Younger patient age was significantly associated with a lower degree of satisfaction. DGR provides good cosmetic results compared with SE and shows high patient satisfaction despite longer scarring and higher median resection volume.

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Figures

Figure 1
Figure 1
Patient of 43 years, ypT0pN0 resection volume 30 g, cup 75C.
Figure 2
Figure 2
19-month follow-up; scar length 25 cm; patient was very satisfied with cosmetic result; BCCT.core: good; the scar visibility was rated as slightly visible by the patient and the experts, and the volume discrepancy was rated slight by the patient and not at all by the experts.
Figure 3
Figure 3
Patient of 46 years, pT2pN2, resection volume 55 g, cup 80C, frontal view.
Figure 4
Figure 4
Same patient, oblique view.
Figure 5
Figure 5
Same patient, 19-month follow-up; scar length 25 cm; BCCT.core: excellent. The patient was very satisfied with the cosmetic result. The scar visibility was rated as very visible by the patient and moderately visible by the experts. The volume discrepancy was rated as slight by the patient and not at all by the experts; frontal view.
Figure 6
Figure 6
Same patient at 19-month follow-up, oblique view.
Figure 7
Figure 7
Patient of 69 years, pT2, pN0, resection volume 61 g, cup 80B, frontal view.
Figure 8
Figure 8
Same patient, oblique view.
Figure 9
Figure 9
Same patient, 18-month follow-up, frontal view; scar length 27 cm; BCCT.core: fair. The patient was very satisfied with the cosmetic result. The scar visibility was rated as slightly visible by the patient and moderately visible by the experts. The volume discrepancy was rated as slight by the patient and experts.
Figure 10
Figure 10
Same patient at 18-month follow-up, oblique view.
Figure 11
Figure 11
Distribution of brassiere cup size.
Figure 12
Figure 12
Dermoglandular rotation flap: correlation between resection volume and difference in the breast volume (subjective rating of the expert panel).
See this image and copyright information in PMC

References

    1. Fisher B., Anderson S., Bryant J., et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. The New England Journal of Medicine. 2002;347(16):1233–1241. doi: 10.1056/NEJMoa022152. - DOI - PubMed
    1. Veronesi U., Cascinelli N., Mariani L., Greco M., Saccozzi R., Luini A., Aguilar M., Marubini E. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. The New England Journal of Medicine. 2002;347(16):1227–1232. doi: 10.1056/NEJMoa020989. - DOI - PubMed
    1. Yeo W., Kwan W. H., Teo P. M. L., Leung W. T., King W., Johnson P. J. Cosmetic outcome of breast-conserving therapy in Chinese patients with early breast cancer. Australian and New Zealand Journal of Surgery. 1997;67(11):771–774. doi: 10.1111/j.1445-2197.1997.tb04577.x. - DOI - PubMed
    1. Berrino P., Campora E., Santi P. Postquadrantectomy breast deformities: classification and techniques of surgical correction. Plastic and Reconstructive Surgery. 1987;79(4):567–572. doi: 10.1097/00006534-198704000-00010. - DOI - PubMed
    1. Clough K. B., Cuminet J., Fitoussi A., Nos C., Mosseri V. Cosmetic sequelae after conservative treatment for breast cancer: classification and results of surgical correction. Annals of Plastic Surgery. 1998;41(5):471–481. doi: 10.1097/00000637-199811000-00004. - DOI - PubMed