Evaluation of Cosmetic Outcomes of the Bilateral Reduction Mammoplasty Following the Breast Conserving Surgery and Unilateral Radiotherapy in Patients With Breast Cancer

Omid  Etemad; Hojjat  Molaie; Ghasem Ali  Khorasani; Ali  Yavari; Changiz  Delavari

doi:10.18502/acta.v63i5.20346

Omid Etemad Department of Plastic and Reconstructive Surgery, Mazandaran University of Medical Sciences, Sari, Iran
Hojjat Molaie Department of Plastic and Reconstructive Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Ghasem Ali Khorasani Department of Plastic and Reconstructive Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Ali Yavari Department of Plastic and Reconstructive Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Changiz Delavari Department of Plastic and Reconstructive Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/acta.v63i5.20346

Keywords: Breast cancer; Mammoplasty; Breast conservative surgery; Radiotherapy

Abstract

Breast asymmetry and deformity are some of the consequences of unilateral breast-conserving surgery in patients with breast cancer, which is also associated with adverse psychological effects. The treatment protocol for these patients may include radiation therapy and surgical procedures, which can affect the cosmetic results in the breast. In this study, 20 patients with breast cancer who underwent reduction mammoplasty surgery after tumor removal were studied. Depending on the location and size of the tumor, it was removed with appropriate margins, and mammoplasty was performed for all patients. After surgery, the patients were referred to a radiotherapist for adjuvant treatment. The breast in which the tumor was located received radiotherapy (case), and the healthy breast was left without adjuvant treatment (control). We evaluated the cosmetic results in these patients 6 months after radiotherapy. The mean age and BMI of the patients were 46.45 years and 26.42 kg/m2, respectively. Thirteen patients were reported to have no comorbidities (65%), and four patients had diabetes (20%). Two of them had hypertension (10%), and one of them had diabetes and hypertension (10%). In seven patients, the tumor was located in the left breast, and the rest in the right. None of these parameters was significantly associated with the cosmetic results of the surgery. Surgical complications were reported in three patients with erythema (15%), in one patient with infection (5%), and in none of the patients without complications (0%). There was no significant difference in the scar score between the control and case groups. Given the negligible association between quantitative cosmetic outcomes in case and control breasts and the similar mammoplasty procedure with the same removal volume on both sides, it seems that different tissue weights need not be removed to achieve symmetry. The Vancouver Scar Score for the case and control sides showed a reduction in scar formation with radiotherapy. However, since the therapeutic dose of radiation is associated with systemic and local complications (erythema, infection, etc.), prophylactic local radiotherapy and brachytherapy could be considered in a risk-benefit study.