Stefano Bonomi, André Salval, Gaetano Musumarra and Fernanda Settembrini
Purpose: Oncoplastic surgical techniques are nowadays the gold standard in breast conservation therapy and following the right timing is mandatory in order to obtain a more than average cosmetic and functional result.
Materials and methods: The goal of the study is to consider the timing of oncoplastic reduction mammaplasty relative to the radiation by drawing a retrospective study that encompassed 19 consecutive patients who had oncoplastic reduction mammaplasty with patients classified into 3 groups: patients having breast conservation and reduction mammaplasty before radiotherapy, patients having reduction mammaplasty within the time interval between lumpectomy and radiation therapy, and patients having reduction mammaplasty after both lumpectomy and radiation therapy. A questionnaire has been used to assess quality of life and patient satisfaction following reduction mammoplasty.
Results: Nine patients had reduction mammoplasty immediately following partial mastectomy, four had reduction surgery in the delayed-immediate period, and six had delayed reduction mammoplasty. Patient satisfaction was very high among the immediate and delayed-immediate groups. Aesthetic assessment for the delayed group was lower but did not reach any significance when compared against the other groups.
Conclusion: Ninety percent of patients reported that they would have elected to undergo the procedure again based on their experience and aesthetic outcome. Complications are more frequent in the delayed setting.
Clinical implications: Oncoplastic surgery increases the oncological safety of BCT as larger breast volume can be excised resulting in larger respective specimens than with partial mastectomy alone. A contralateral reduction mammaplasty can be performed to obtain symmetry and balance, with consequent “surgical screening” of the contralateral breast.