Breast Reduction in Patients with Prior Breast Irradiation: Outcomes Using a Central Mound Technique

Katie E. Weichman, Leo Urbinelli, Joseph J. Disa, Babak J. Mehrara

Research output: Contribution to journalArticle

4 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1276-1282
Number of pages7
JournalPlastic and reconstructive surgery
Volume135
Issue number5
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

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Breast
Mammaplasty
Fat Necrosis
Segmental Mastectomy
Nipples
Wound Healing
Case-Control Studies
Dissection
Necrosis
Breast Neoplasms
Biopsy
Safety
Weights and Measures
Incidence

ASJC Scopus subject areas

  • Surgery

Cite this

Breast Reduction in Patients with Prior Breast Irradiation : Outcomes Using a Central Mound Technique. / Weichman, Katie E.; Urbinelli, Leo; Disa, Joseph J.; Mehrara, Babak J.

In: Plastic and reconstructive surgery, Vol. 135, No. 5, 01.01.2015, p. 1276-1282.

Research output: Contribution to journalArticle

Weichman, Katie E. ; Urbinelli, Leo ; Disa, Joseph J. ; Mehrara, Babak J. / Breast Reduction in Patients with Prior Breast Irradiation : Outcomes Using a Central Mound Technique. In: Plastic and reconstructive surgery. 2015 ; Vol. 135, No. 5. pp. 1276-1282.
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