Superomedial Versus Inferior Pedicle Therapeutic Reduction Mammoplasty for Breast Cancer Patients with 35–40 cm Sternal Notch-to-Nipple Distance

Therapeutic mammoplasty is a well-established option for breast cancer treatment when indicated by oncological evaluation. At sternal notch-to-nipple (SN-N) distances above 35cm, the inferior pedicle (IFP) technique is often considered most reliable due to its vascular supply, potentially reducing complications. However, the superomedial pedicle (SMP) technique is associated with better aesthetic outcomes. We compared SMP and IFP outcomes at SN-N distances of 35–40 cm.

A retrospective cohort study was conducted, including 81 breast cancer patients (43 SMP, 38 IFP), who underwent therapeutic mammoplasty with an SN-N distance of 35–40 cm. Outcomes compared included operative time, nipple–areola complex (NAC) viability, postoperative complications, and patient satisfaction with breasts, outcomes, and nipples.

The mean SN-N distance was not statistically different between groups. Mean operative time was shorter with SMP than with IFP (88.21 ± 5.07 vs. 119.3 ± 5.60 minutes, p < 0.001). NAC viability did not differ significantly, with partial necrosis in 4.7% of SMP patients and 2.6% of IFP patients (p = 1.000). Other postoperative complications were rare, with one infection in each group. SMP patients reported higher satisfaction with breasts (88.77 ± 7.23 vs 75.71 ± 8.03, p <0.001) and outcomes (90.60 ± 8.19 vs 76.42 ± 8.76, p < 0.001). Satisfaction with nipples was high in both groups without a significant difference.

SMP demonstrates comparable or superior outcomes to IFP at SN-N distances of 35–40 cm, expanding the applicability of the superomedial pedicle technique.

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Full size image