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Inverted-T pattern mastectomy safe for patients with large or ptotic breasts
The inverted-T pattern mastectomy approach was performed safely and had acceptable complication rates when compared with traditional horizontal elliptical mastectomy, according to study results.
“Patients with large or ptotic breasts undergoing mastectomy followed by tissue expander/implant-based reconstruction may benefit from a Wise (inverted-T) pattern reduction mammoplasty incision compared with the traditional horizontal elliptical incision,” the researchers wrote.
The researchers created a database to identify 69 patients (mean age, 53 years) undergoing inverted-T pattern mastectomy and two-stage reconstruction (117 breasts) from 2008 to 2011. The patients were compared with a control cohort of 89 patients (mean age, 54.1 years) who underwent reconstruction after horizontal elliptical mastectomy (136 breasts) during the same period.
The cohorts displayed differences in mean BMI (controls, 26.7 kg/m2; inverted-T, 28.7 kg/m2; P = .04) and mean intraoperative fill volume (controls, 158.7 cc; inverted-T, 196.9 cc; P = .02). Other patient demographics, including diabetes, smoking and irradiation history, and clinical characteristics, including laterality, expander size and time to expansion) were similar between the cohorts.
No significant difference was observed in complications, including infection, seroma, expander loss and salvage. Patients undergoing inverted-T mastectomy, however, had a greater rate of mastectomy flap necrosis compared with control patients (25.6% vs. 11%; P = .002).
“The inverted-T mastectomy for staged prosthetic breast reconstruction benefits patients with large or ptotic breasts by creating a more natural breast shape and improved symmetry,” the researchers wrote.
“The inverted-T mastectomy approach can be performed safely in patients undergoing staged or tissue expander breast reconstruction, with acceptable complication rates,” the researchers concluded. “Although mastectomy flap necrosis is more commonly associated with this procedure, judicious debridement combined with the inferiorly based dermal flap prevents progression to infection, exposure, and expander loss.” – by Bruce Thiel
Disclosure: The researchers report no relevant financial disclosures.