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Central mound technique offers reliable, reproducible results in lumpectomy, irradiation patients

Breast reduction using the central mound technique was found to be effective in patients with a history of irradiation and lumpectomy, producing reliable and reproducible results when patients were selected carefully, according to study findings.

The study comprised all patients who underwent bilateral breast reduction mammoplasty between 2008 and 2013 at Memorial Sloan Kettering Cancer Center, including patients who underwent unilateral breast irradiation and bilateral reduction with the central mound technique. Each patient had a control breast and an irradiated breast, comprising two cohorts.

Across the patient population, comorbidities included hypertension (23.1%), hypothyroidism (15.4%), asthma (15.4%) and diabetes mellitus (7.7%). Former smokers accounted for 46.2% of the patients, but all had stopped smoking for more than 5 years prior to the reduction mammoplasty procedure.

Most patients (53.8%) had stage 2 disease, 38.5% of patients had stage 1 and one patient had a history of stage 3 disease. Chemotherapy was used in 53.8% of patients.

In all cases, the control breast weight was greater than the irradiated specimen weight, with a mean difference between the control and irradiated breasts of 132.6 g. On average, the irradiated breasts were 36.7% smaller than the controls.

Among the 13 patients included in the study, no significant differences were observed in the incidences of any complication between groups, and no incidence of partial or complete nipple-areola necrosis was reported, according to the researchers.

The researchers concluded that the observed low complication rate was attributable to use of the central mound surgical technique with minimal skin elevation.

Overall, the researchers recommended careful patient selection by excluding patients with unfavorable biopsy scars or skin damage from radiation therapy, as well as the inclusion of patients with an average time period of 41.3 months from radiation therapy. – by Abigail Sutton

Disclosure: The researchers report no relevant financial disclosures.