Tumor quadrantectomy combined with reduction mammaplasty for the treatment of breast cancer

BACKGROUND: Tumor quadrantectomy combined with reduction mammaplasty allows resection of breast cancer with wider free margins and an improved cosmetic result. METHODS: 121 women with 125 breast cancers (114 invasive cancers, 11 high grade DCIS) underwent tumor quadrantectomy combined with a reduction mammaplasty. The oncological and cosmetic outcome is evaluated. RESULTS: Reduction mammaplasties were performed unilaterally (n = 4/121) or bilaterally (n = 117/121). Mean free surgical margins were 11.8 mm in patients with invasive cancer and 18.6 mm in patients with high grade DCIS. 3 of 125 resection specimen revealed positive margins (all were DCIS), in 2 of 125 specimens multicentric invasive cancer was found and the 5 patients underwent secondary mastectomy with immediate reconstruction. In 4 of 117 patients an occult invasive cancer was found in the histological specimen of the contralateral breast. After a median follow-up of 32 months (range 11–106 months) there were no local recurrences in the breast or axilla, three patients developed distant metastases. The postoperative cosmetic result evaluated by the patients was rated as excellent in 97 of 121 patients (80%) and good in 24 of 121 patients (20%) with no poor result. CONCLUSIONS: Tumor quadrantectomy combined with reduction mammaplasty allows wide tumor resection with adequate cosmetic result.