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Oncoplastic Breast Reconstruction in a Breast Re-Reduction Case

Nicholas I. Koenig, Zachary A. Koenig, Mihail Climov, & H. Safak Uygur
West Virginia University
2023-01-31

Presenter: Nicholas I. Koenig

Affidavit:
I certify that this abstract has not been published in any scientific journal or previously presented at a major meeting.

Director Name: Kerri M. Woodberry

Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)

Introduction
Breast conservation therapy typically consists of lumpectomy, which often leads to poor cosmetic outcomes. Concurrent oncoplastic reductions are performed to maximize aesthetics and patient outcome. We present an oncoplastic breast reconstruction in a breast re-reduction case in this study.

Case presentation
A 62-year-old female was diagnosed with invasive ductal carcinoma of the left upper outer breast by core needle biopsy. The patient had a prior bilateral breast reduction using a superior-central pedicle approach 15 years ago. As our oncoplastic reconstruction technique, we chose superomedial pedicle Wise-Pattern bilateral breast reduction.

The lump was excised lateral to the pedicle after initial de-epithelialization and incision of the superomedial pedicle's lateral aspect. The remainder of the pedicle was developed, and the same procedure was performed on the right breast at the same time. Excess tissue was excised bilaterally from the medial, superior, and inferior, and the optimal new nipple position was obtained. Both nipples were viable and well perfused following closure of the incisions.

Discussion
Breast cancer is uncommon in patients who have had bilateral breast reductions. Oncoplastic reduction is an uncommon procedure used in patients who want to preserve their breasts while maintaining their aesthetic appearance. There is currently no agreement on the safest and most effective surgical technique for breast re-reduction surgery, and no reports on oncoplastic reconstruction in patients requiring breast re-reductions. In an oncoplastic reconstruction case, we achieved an acceptable outcome with our superomedial pedicled wise pattern bilateral breast reduction technique.

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