Breast reduction in patients with prior breast irradiation: Outcomes using a central mound technique Journal Article


Authors: Weichman, K. E.; Urbinelli, L.; Disa, J. J.; Mehrara, B. J.
Article Title: Breast reduction in patients with prior breast irradiation: Outcomes using a central mound technique
Abstract: BACKGROUND: Breast reduction in patients with a history of lumpectomy and irradiation is controversial because of a heightened risk of infection and wound healing complications. Persistent macromastia or asymmetry remains a problem in this patient population that is commonly not addressed. The authors studied the safety and efficacy of a central mound technique with minimal dissection for breast reduction or mastopexy in patients with a history of breast irradiation. METHODS: A case-control study of all patients undergoing bilateral breast reduction mammaplasty between 2008 and 2013 at Memorial Sloan Kettering Cancer Center was conducted. Patients who had unilateral breast irradiation and bilateral reduction using the central mound technique were included. Each patient had a control breast and an irradiated breast. Complications and outcomes were analyzed. RESULTS: Thirteen patients were included for analysis. Their average age was 50.23 ± 9.9 years, and average time from irradiation to breast reduction mammaplasty was 41.3 ± 48.5 months (range, 9 to 132 months). The average specimen weight of irradiated breasts was less than that of control breasts; however, this failed to reach statistical significance (254.2 ± 173.5 g versus 386.9 ± 218.5 g; p = 0.099). One patient developed fat necrosis in the previously irradiated breast and underwent biopsy. There was no incidence of nipple necrosis or breast cancer in either irradiated or nonirradiated breasts. CONCLUSIONS: Breast reduction mammaplasty in patients who have had irradiation is feasible and can be performed safely in select cases. The central mound technique provides reliable and reproducible results and should be considered in patients with macromastia/asymmetry and a history of irradiation. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
Keywords: adult; treatment outcome; middle aged; retrospective studies; follow up; follow-up studies; mastectomy; breast neoplasms; breast reconstruction; mammaplasty; retrospective study; nipple; nipples; procedures; humans; human; female
Journal Title: Plastic and Reconstructive Surgery
Volume: 135
Issue: 5
ISSN: 0032-1052
Publisher: Lippincott Williams & Wilkins  
Date Published: 2015-05-01
Start Page: 1276
End Page: 1282
Language: English
DOI: 10.1097/prs.0000000000001147
PUBMED: 25919242
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 3 August 2015 -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Joseph Disa
    262 Disa
  2. Babak Mehrara
    448 Mehrara