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Lumpectomy Reconstruction-immediate and late options
William C. Rigano MD
R Michael Johnson MD
Wright State University, Division of Plastic Surgery
2013-02-27
Presenter: William C Rigano MD
Affidavit:
This is 100% of one of the volunteer faculty
Director Name: R Michael Johnson MD
Presentation Category: ClinicalAbstract Category: Breast (Aesthetic and Recon.)
Partial breast reconstruction improves quality of life when performed immediately after lumpectomy. Opposite breast surgery provides excellent long term symmetry and minimizes recovery when performed simultaneously.Late reconstruction after radiation improves patient satisfaction and can be performed safely as an outpatient in selective cases.
METHODS: The author retrospectively reviewed all patients between 2003 and 2012 who underwent partial breast (lumpectomy) reconstruction. Patient satisfaction, softness, and symmetry were evaluated. Re-operation rates and complications were analyzed.
RESULTS:9 immediate lumpectomy reconstructions underwent parenchymal rearrangements and opposite breast reduction. No re-operations were needed. Softness and symmetry were excellent with no evidence of recurrence(6mos-9years).26 patients had reconstruction after radiation(24mos-5 yrs).24 patients had opposite breast surgery for symmetry.4 had parenchymal rearrangement, 15 implant reconstruction,6 lat dorsi flaps, and 2 opposite breast reduction only. Complications in these patients included 2 re-operations for symmetry,one infection, and one grade 2 capsular contracture.
CONCLSIONS: Immediate lumpectomy reconstruction has a low incidence of complications and high patient satisfaction. Excellent long term symmetry and softness allow easy clinical and mammographic surveilance. Late lumpectomy reconstruction can be safely performed after post-radiation changes stabilize. Implants can be used with other techniques in carefully selected patients. A low incidence of capsular contracture and other complications give patients high satisfaction.
