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

Hille-Betz U, Vaske B, Henseler H, Soergel P, Kundu S, Makowski L, Schelcher S, Wojcinski S, Hillemanns P - Int J Breast Cancer (2014)

Bottom Line: 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).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.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Hannover Medical School, 30625 Hannover, Germany.

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.

No MeSH data available.


Related in: MedlinePlus

Same patient, oblique view.
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fig8: Same patient, oblique view.

Mentions: In tumors in the lower inner quadrant, the skin incision was extended along the submammary fold, and the mammary gland was mobilized on the pectoralis muscle (Figures 1 and 2) [10, 12]. In tumors in the upper inner quadrant, the incision led toward the lateral border of the breast where a mirror inverted triangle of skin was removed (Figures 3, 4, 5, and 6). The mobilization of the upper half of the mammary gland was necessary. After the breast tissue had been readapted, repositioning the NAC was evaluated. If necessary, the NAC was transferred to the center of the new breast dome by deepithelializing a periareolar crescent of skin opposite to the segmentectomy/quadrantectomy (Figures 7, 8, 9, and 10).


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

Hille-Betz U, Vaske B, Henseler H, Soergel P, Kundu S, Makowski L, Schelcher S, Wojcinski S, Hillemanns P - Int J Breast Cancer (2014)

Same patient, oblique view.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4236966&req=5

fig8: Same patient, oblique view.
Mentions: In tumors in the lower inner quadrant, the skin incision was extended along the submammary fold, and the mammary gland was mobilized on the pectoralis muscle (Figures 1 and 2) [10, 12]. In tumors in the upper inner quadrant, the incision led toward the lateral border of the breast where a mirror inverted triangle of skin was removed (Figures 3, 4, 5, and 6). The mobilization of the upper half of the mammary gland was necessary. After the breast tissue had been readapted, repositioning the NAC was evaluated. If necessary, the NAC was transferred to the center of the new breast dome by deepithelializing a periareolar crescent of skin opposite to the segmentectomy/quadrantectomy (Figures 7, 8, 9, and 10).

Bottom Line: 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).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.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Hannover Medical School, 30625 Hannover, Germany.

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.

No MeSH data available.


Related in: MedlinePlus