Skip to main content
Top
Published in: Annals of Surgical Oncology 12/2013

01-11-2013 | Breast Oncology

Level 2 Oncoplastic Surgery for Lower Inner Quadrant Breast Cancers: The LIQ-V Mammoplasty

Authors: Krishna B. Clough, MD, Stephane Oden, MD, Tarik Ihrai, MD, Eleanore Massey, MRCS, Claude Nos, MD, Isabelle Sarfati, MD

Published in: Annals of Surgical Oncology | Issue 12/2013

Login to get access

Abstract

Background

Oncoplastic surgical techniques offer an option of breast conserving surgery for larger tumors with the use of glandular reshaping to prevent postoperative deformity. A technique for the excision of lower inner quadrant tumors via a V incision is described, the lower-inner quadrant-V (LIQ-V) mammoplasty, and the results of a pilot study are reported.

Methods

Retrospective collection of pre- and postoperative data was collected from patients undergoing a LIQ-V mammoplasty for a LIQ tumor.

Results

Twenty-two patients were operated on between 2004 and 2011 at a mean age of 58 years. The mean follow-up was 55 months. The mean resection weight was 101 g for tumors ranging in size from 4 to 31 mm. The margins were clear in 95 % of cases. There was one case of local recurrence and metastatic disease. The cosmetic outcome was judged as excellent in 68 % of cases, and no patient required further ipsilateral or contralateral symmetrizing surgery.

Discussion

The deformity often associated with tumors of the LIQ is adequately addressed by this new technique. It has a complication rate comparable to other mammoplasty series and a high rate of clear resection margins. Many oncoplastic surgery techniques are based on inverted T mammoplasty, but these are not suited for all tumor locations. The LIQ-V mammoplasty is an adaptation of the standard techniques that best suit the LIQ. It is oncologically safe and provides disease-free margins, and although the resection volumes are large, the cosmetic outcome is not compromised.
Appendix
Available only for authorised users
Literature
1.
go back to reference Blichert-Toft M, et al. Long-term results of breast conserving surgery vs. mastectomy for early stage invasive breast cancer: 20-year follow-up of the Danish randomized DBCG-82TM protocol. Acta Oncol. 2008;47:672–81.PubMedCrossRef Blichert-Toft M, et al. Long-term results of breast conserving surgery vs. mastectomy for early stage invasive breast cancer: 20-year follow-up of the Danish randomized DBCG-82TM protocol. Acta Oncol. 2008;47:672–81.PubMedCrossRef
2.
go back to reference Fisher B, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347:1233–41.PubMedCrossRef Fisher B, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347:1233–41.PubMedCrossRef
3.
go back to reference Poggi MM, et al. Eighteen-year results in the treatment of early breast carcinoma with mastectomy versus breast conservation therapy: the National Cancer Institute Randomized Trial. Cancer. 2003;98:697–702.PubMedCrossRef Poggi MM, et al. Eighteen-year results in the treatment of early breast carcinoma with mastectomy versus breast conservation therapy: the National Cancer Institute Randomized Trial. Cancer. 2003;98:697–702.PubMedCrossRef
4.
go back to reference van Dongen JA, et al. Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy. European Organization for Research and Treatment of Cancer 10801 trial. J Natl Cancer Inst. 2000;92:1143–50.PubMedCrossRef van Dongen JA, et al. Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy. European Organization for Research and Treatment of Cancer 10801 trial. J Natl Cancer Inst. 2000;92:1143–50.PubMedCrossRef
5.
go back to reference Veronesi U, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347:1227–32.PubMedCrossRef Veronesi U, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347:1227–32.PubMedCrossRef
6.
go back to reference Clough KB, et al. Mammoplasty combined with irradiation: conservative treatment of breast cancer localized in the lower quadrant. Ann Chir Plast Esthet. 1990;35:117–22.PubMed Clough KB, et al. Mammoplasty combined with irradiation: conservative treatment of breast cancer localized in the lower quadrant. Ann Chir Plast Esthet. 1990;35:117–22.PubMed
7.
go back to reference Clough KB, et al. Conservative treatment of breast cancers by mammaplasty and irradiation: a new approach to lower quadrant tumors. Plast Reconstr Surg. 1995;96:363–70.PubMedCrossRef Clough KB, et al. Conservative treatment of breast cancers by mammaplasty and irradiation: a new approach to lower quadrant tumors. Plast Reconstr Surg. 1995;96:363–70.PubMedCrossRef
8.
go back to reference Clough KB, Kroll SS, Audretsch W. An approach to the repair of partial mastectomy defects. Plast Reconstr Surg. 1999;104:409–20.PubMedCrossRef Clough KB, Kroll SS, Audretsch W. An approach to the repair of partial mastectomy defects. Plast Reconstr Surg. 1999;104:409–20.PubMedCrossRef
9.
go back to reference Clough KB, et al. Improving breast cancer surgery: a classification and quadrant per quadrant atlas for oncoplastic surgery. Ann Surg Oncol. 2010;17:1375–91.PubMedCrossRef Clough KB, et al. Improving breast cancer surgery: a classification and quadrant per quadrant atlas for oncoplastic surgery. Ann Surg Oncol. 2010;17:1375–91.PubMedCrossRef
10.
go back to reference Clough KB, et al. Cosmetic sequelae after conservative treatment for breast cancer: classification and results of surgical correction. Ann Plast Surg. 1998;41:471–81.PubMedCrossRef Clough KB, et al. Cosmetic sequelae after conservative treatment for breast cancer: classification and results of surgical correction. Ann Plast Surg. 1998;41:471–81.PubMedCrossRef
11.
go back to reference Clough KB, et al. Oncoplastic techniques allow extensive resections for breast-conserving therapy of breast carcinomas. Ann Surg. 2003;237:26–34.PubMedCrossRef Clough KB, et al. Oncoplastic techniques allow extensive resections for breast-conserving therapy of breast carcinomas. Ann Surg. 2003;237:26–34.PubMedCrossRef
12.
go back to reference McCulley SJ, Macmillan RD. Therapeutic mammaplasty—analysis of 50 consecutive cases. Br J Plast Surg. 2005;58:902–7.PubMedCrossRef McCulley SJ, Macmillan RD. Therapeutic mammaplasty—analysis of 50 consecutive cases. Br J Plast Surg. 2005;58:902–7.PubMedCrossRef
13.
go back to reference Munhoz AM, et al. Critical analysis of reduction mammaplasty techniques in combination with conservative breast surgery for early breast cancer treatment. Plast Reconstr Surg. 2006;117:1091–103.PubMedCrossRef Munhoz AM, et al. Critical analysis of reduction mammaplasty techniques in combination with conservative breast surgery for early breast cancer treatment. Plast Reconstr Surg. 2006;117:1091–103.PubMedCrossRef
14.
go back to reference Kronowitz SJ, et al. Practical guidelines for repair of partial mastectomy defects using the breast reduction technique in patients undergoing breast conservation therapy. Plast Reconstr Surg. 2007;120:1755–68.PubMedCrossRef Kronowitz SJ, et al. Practical guidelines for repair of partial mastectomy defects using the breast reduction technique in patients undergoing breast conservation therapy. Plast Reconstr Surg. 2007;120:1755–68.PubMedCrossRef
15.
go back to reference Amichetti M, Busana L, Caffo O. Long-term cosmetic outcome and toxicity in patients treated with quadrantectomy and radiation therapy for early-stage breast cancer. Oncology. 1995;52:177–81.PubMedCrossRef Amichetti M, Busana L, Caffo O. Long-term cosmetic outcome and toxicity in patients treated with quadrantectomy and radiation therapy for early-stage breast cancer. Oncology. 1995;52:177–81.PubMedCrossRef
16.
go back to reference Giacalone PL, et al. Comparative study of the accuracy of breast resection in oncoplastic surgery and quadrantectomy in breast cancer. Ann Surg Oncol. 2007;14:605–14.PubMedCrossRef Giacalone PL, et al. Comparative study of the accuracy of breast resection in oncoplastic surgery and quadrantectomy in breast cancer. Ann Surg Oncol. 2007;14:605–14.PubMedCrossRef
17.
go back to reference Ballester M, et al. Lateral mammaplasty reconstruction after surgery for breast cancer. Br J Surg. 2009;96:1141–6.PubMedCrossRef Ballester M, et al. Lateral mammaplasty reconstruction after surgery for breast cancer. Br J Surg. 2009;96:1141–6.PubMedCrossRef
18.
go back to reference Fitoussi AD, et al. Oncoplastic breast surgery for cancer: analysis of 540 consecutive cases (outcomes article). Plast Reconstr Surg. 2010;125:454–62.PubMedCrossRef Fitoussi AD, et al. Oncoplastic breast surgery for cancer: analysis of 540 consecutive cases (outcomes article). Plast Reconstr Surg. 2010;125:454–62.PubMedCrossRef
19.
go back to reference Berry MG, et al. Oncoplastic breast surgery: a review and systematic approach. J Plast Reconstr Aesthet Surg. 2010;63:1233–43.PubMedCrossRef Berry MG, et al. Oncoplastic breast surgery: a review and systematic approach. J Plast Reconstr Aesthet Surg. 2010;63:1233–43.PubMedCrossRef
20.
go back to reference Clough KB, et al. Oncoplastic surgery for breast cancer based on tumor location and a quadrant per quadrant atlas. Br J Surg. 2012;99:1389–95.PubMedCrossRef Clough KB, et al. Oncoplastic surgery for breast cancer based on tumor location and a quadrant per quadrant atlas. Br J Surg. 2012;99:1389–95.PubMedCrossRef
21.
go back to reference Kaur N, et al. Comparative study of surgical margins in oncoplastic surgery and quadrantectomy in breast cancer. Ann Surg Oncol. 2005;12:539–45.PubMedCrossRef Kaur N, et al. Comparative study of surgical margins in oncoplastic surgery and quadrantectomy in breast cancer. Ann Surg Oncol. 2005;12:539–45.PubMedCrossRef
22.
go back to reference Nos C, et al. Conservative treatment of lower pole breast cancers by bilateral mammoplasty and radiotherapy. Eur J Surg Oncol. 1998;24:508–14.PubMedCrossRef Nos C, et al. Conservative treatment of lower pole breast cancers by bilateral mammoplasty and radiotherapy. Eur J Surg Oncol. 1998;24:508–14.PubMedCrossRef
23.
go back to reference Huemer GM, et al. Oncoplastic techniques allow breast-conserving treatment in centrally located breast cancers. Plast Reconstr Surg. 2007;120:390–8.PubMedCrossRef Huemer GM, et al. Oncoplastic techniques allow breast-conserving treatment in centrally located breast cancers. Plast Reconstr Surg. 2007;120:390–8.PubMedCrossRef
24.
go back to reference Staub G, et al. Breast cancer surgery: use of mammaplasty. Results. Series of 298 cases. Ann Chir Plast Esthet. 2008;53:124–34.PubMedCrossRef Staub G, et al. Breast cancer surgery: use of mammaplasty. Results. Series of 298 cases. Ann Chir Plast Esthet. 2008;53:124–34.PubMedCrossRef
25.
go back to reference Rietjens M, et al. Long-term oncological results of breast conservative treatment with oncoplastic surgery. Breast. 2007;16:387–95.PubMedCrossRef Rietjens M, et al. Long-term oncological results of breast conservative treatment with oncoplastic surgery. Breast. 2007;16:387–95.PubMedCrossRef
26.
go back to reference Turnbull L, et al. Comparative effectiveness of MRI in breast cancer (COMICE) trial: a randomised controlled trial. Lancet. 2010;375(9714):563–71.PubMedCrossRef Turnbull L, et al. Comparative effectiveness of MRI in breast cancer (COMICE) trial: a randomised controlled trial. Lancet. 2010;375(9714):563–71.PubMedCrossRef
Metadata
Title
Level 2 Oncoplastic Surgery for Lower Inner Quadrant Breast Cancers: The LIQ-V Mammoplasty
Authors
Krishna B. Clough, MD
Stephane Oden, MD
Tarik Ihrai, MD
Eleanore Massey, MRCS
Claude Nos, MD
Isabelle Sarfati, MD
Publication date
01-11-2013
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 12/2013
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-013-3085-4

Other articles of this Issue 12/2013

Annals of Surgical Oncology 12/2013 Go to the issue