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Objectives <p>Therapeutic mammoplasty (TM) combines breast-conserving surgery (BCS) with reduction mammoplasty, aiming to preserve breast contour while ensuring oncological safety. We report surgical outcomes of TM performed at our tertiary cancer center over the last five years.</p> Materials &amp; Methods <p>The retrospective analysis of prospectively maintained database included 141 consecutive breast cancer patients who underwent TM between January 2019 and December 2024. Data were retrieved from institutional records. Statistical analysis was performed using SPSS version 24 and Stata version 14.</p> Results <p>A total of 263 TM procedures were performed in 141 patients, with immediate contralateral symmetrisation in 122 (86.5%). Most patients had D-cup (50.8%) or C-cup (28.2%) breasts. The primary indication for TM was to avoid mastectomy while improving quality of life. The Wise pattern technique was used in 98% of cases. Additional procedures were required in 58 patients (41%), most commonly a secondary pedicle (36%) and free nipple-areola complex (NAC) graft (33%). Median tumour size was 3&#xa0;cm (IQR: 3–5&#xa0;cm), and median specimen weight was 516&#xa0;g (IQR: 377–705&#xa0;g). Margin positivity requiring re-excision occurred in 4 patients (2.8%).Postoperative complications occurred in 16 patients (11.3%), including 6 Clavien-Dindo grade III events. Eight patients (5.6%) were readmitted within 30 days—4 for re-excision for positive margin, 1 for completion axillary clearance, and 3 for wound-related issues. No significant association was found between complications and diabetes, obesity, age, breast size, ptosis, specimen weight, or additional procedures. The median time to initiation of adjuvant therapy was 55 days (IQR: 38–68), with no significant delay due to complications (Kaplan-Meier log-rank <i>p</i> = 0.78). The 5-year predicted overall survival was 95%, with 9 deaths recorded, predominantly due to cancer. Patient-reported outcomes demonstrated high satisfaction, with 96% satisfied with scar appearance, 100% comfortable in public, 99% satisfied with their decision, and 84% reporting satisfaction with breast symmetry.</p> Conclusions <p>TM is a safe and effective option for selected breast cancer patients with medium to large breasts, offering low complication and re-excision rates, and no delay in adjuvant therapy, even in patients with comorbidities.</p>

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“Oncoplastic Breast Surgery with Therapeutic Mammoplasty: Surgical Outcomes and Insights from a High-Volume Tertiary Cancer Centre in India”

  • 期刊论文

  • 发表日期：

    2026年5月9日

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  • Sanjit Kumar Agrawal,
  • Meenulochani Annadurai,
  • Ramyalakshmi K. G.,
  • Rosina Ahmed,
  • Abhishek Sharma,
  • Shagun Mahajan

摘要

Objectives

Therapeutic mammoplasty (TM) combines breast-conserving surgery (BCS) with reduction mammoplasty, aiming to preserve breast contour while ensuring oncological safety. We report surgical outcomes of TM performed at our tertiary cancer center over the last five years.

Materials & Methods

The retrospective analysis of prospectively maintained database included 141 consecutive breast cancer patients who underwent TM between January 2019 and December 2024. Data were retrieved from institutional records. Statistical analysis was performed using SPSS version 24 and Stata version 14.

Results

A total of 263 TM procedures were performed in 141 patients, with immediate contralateral symmetrisation in 122 (86.5%). Most patients had D-cup (50.8%) or C-cup (28.2%) breasts. The primary indication for TM was to avoid mastectomy while improving quality of life. The Wise pattern technique was used in 98% of cases. Additional procedures were required in 58 patients (41%), most commonly a secondary pedicle (36%) and free nipple-areola complex (NAC) graft (33%). Median tumour size was 3 cm (IQR: 3–5 cm), and median specimen weight was 516 g (IQR: 377–705 g). Margin positivity requiring re-excision occurred in 4 patients (2.8%).Postoperative complications occurred in 16 patients (11.3%), including 6 Clavien-Dindo grade III events. Eight patients (5.6%) were readmitted within 30 days—4 for re-excision for positive margin, 1 for completion axillary clearance, and 3 for wound-related issues. No significant association was found between complications and diabetes, obesity, age, breast size, ptosis, specimen weight, or additional procedures. The median time to initiation of adjuvant therapy was 55 days (IQR: 38–68), with no significant delay due to complications (Kaplan-Meier log-rank p = 0.78). The 5-year predicted overall survival was 95%, with 9 deaths recorded, predominantly due to cancer. Patient-reported outcomes demonstrated high satisfaction, with 96% satisfied with scar appearance, 100% comfortable in public, 99% satisfied with their decision, and 84% reporting satisfaction with breast symmetry.

Conclusions

TM is a safe and effective option for selected breast cancer patients with medium to large breasts, offering low complication and re-excision rates, and no delay in adjuvant therapy, even in patients with comorbidities.