Tumour-adapted Reduction Mammoplasty – a New (Old) Breast Conserving Strategy: Review

Abstract

Today over 70 % of patients treated for primary breast carcinoma in certified breast centres are managed with breast conserving surgery. The classical semicircular incision directly above the tumour, though in many cases easily carried out and associated with good cosmetic results, does have limitations. Unsatisfactory aesthetic results often occur when tumour location is unfavourable or when there is unfavourable tumour size relative to breast size. Distortion of the nipple, changes to breast shape and retraction of skin overlying surgical defects can occur. Tumour-adapted reduction mammoplasty/mastopexy or the “modified B technique” offer excellent chances of combining the oncological demands of breast surgery with satisfactory symmetrical cosmetic results. This article reviews a traditional, old operative technique that has been re-embraced in various new forms.

Zusammenfassung

An einem zertifizierten Brustzentrum können heute mehr als 70 % der Patientinnen mit einem primären Mammakarzinom brusterhaltend operiert werden. Der in vielen Fällen gut durchführbare und von guten kosmetischen Ergebnissen begleitete, klassische Semizirkulärschnitt oberhalb des Tumorsitzes hat allerdings auch seine Limitationen. Bei ungünstigem Tumorsitz oder ungünstiger Relation zwischen Tumor- und Brustgröße kommt es häufig zu einem unbefriedigendem ästhetischen Ergebnis mit Verziehung der Mamille, Veränderung der Brustform oder Einziehung der Brustkontur durch den entstandenen Defekt. Um dies erfolgreich zu vermeiden, bietet die tumoradaptierte Reduktion bzw. Mastopexie oder auch modifizierte B-Plastik exzellente Möglichkeiten, die notwendigen onkologischen Anforderungen an die Brustkrebsoperation mit guten, seitengleichen ästhetischen Ergebnissen zu verbinden. Mit dieser Übersichtsarbeit soll diese eigentlich traditionelle, ältere Operationsmethode, die in verschiedenen neuen Variationen wieder aufgegriffen wurde, vorgestellt werden.

Key words

tumour-adapted reduction - breast carcinoma - breast conserving surgery - Dufourmentel-Mouly mammoplasty - modified B technique

Schlüsselwörter

tumoradaptierte Reduktion - Mammakarzinom - brusterhaltende Operation - Dufourmentel-Mouly-Mammaplastik - modifizierte B-Plastik

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