Evaluation of the Perimamillar Breast-Conserving Surgery as a Standard Level-I Modified Round Block Oncoplastic Breast Surgery

Mihály Újhelyi1*, Mátyás Újlaki2, Ivády Gabriella3, Orsolya Ping1, Szilárd Domján1, Zoltán Takácsi-Nagy4,5, Ákos Sávolt1, István Kenessey6,7, Artefaa Alshamari8, Bence Dorogi9,10 and Zoltán Mátrai1

1Department of Breast and Sarcoma Surgery, National Institute of Oncology, Hungary
2Department of Oncology Imaging and invasive Diagnostic, National Institute of Oncology, Hungary
3Department of Pathology, National Institute of Oncology, Hungary
4Department of Radiotherapy, National Institute of Oncology, Hungary
5Department of Oncology, Semmelweis University, Hungary
6National Cancer Registry, National Institute of Oncology, Hungary
7Second Department of Pathology, Semmelweis University, Hungary
8Hamad General Hospital, Qatar
9Doctoral School of Clinical Medicine, University of Szeged, Hungary
10Department of General, Vascular and Thoracic Surgery, Bajcsy-Zsilinszky Municipal Hospital, Hungary

^*Correspondance to: Mihaly Ujhelyi 

 PDF  Full Text DOI: 10.25107/2474-1647.3407

Abstract

Round block Oncoplastic Breast-Conserving Surgery (OBCS) can cause dilatation of the areola and a sharp periareolar scar that leads to significant asymmetry of the breasts. Here, we modified the round block OBCS by using the tendency of areolar expansion and placing the incision line and de-epithelization of the epidermal layer in the Perimamillar (PM) area rather than in the periareolar area. PM OBCS was indicated for the radical resection of solitary or multifocal malignant tumors (<30 mm) located in any quadrant of the breast. The Breast Q questionnaire, BCCT.core, and Likert scale were used to evaluate the subjective and objective aesthetic results. A prospectively led database of 60 patients was used in this retrospective study. Re-excisions were performed due to involved margins in 5 (8.3%) cases. The median follow-up time was 11 months. In total, 8 (13.3%) grade-I complications and 2 (3.3%) grade-II complications were recorded. The PM OBCS technique did not significantly influence the subjective and objective aesthetic results. High patient satisfaction was observed. The PM OBCS technique is effective Level-I oncoplastic for cT1 breast tumors. Thus, “invisible” surgery could be a realistic expectation. Compared to periareolar de-epithelization, this technique allows better preservation of breast projection.

Keywords

Oncoplastic breast surgery; Round block oncoplasty; Breast cancer

Cite the article

Újhelyi M, Újlaki M, Gabriella I, Ping O, Domján S, Takácsi-Nagy Z, et al. Evaluation of the Perimamillar Breast-Conserving Surgery as a Standard Level-I Modified Round Block Oncoplastic Breast Surgery. Clin Surg. 2022; 7: 3407..