Oncoplastic mammaplasty with geometric compensation--a technique for breast conservation

Objective: To describe a technique of oncoplastic mammaplasty, referred to as geometric compensation, which is suitable for tumors close to the skin in areas not included in the classic preoperative drawings for mammaplasty.

Materials and methods: Seventeen patients with malignant tumors were included. Preoperative markings followed the "Wise-pattern" technique. The resection of affected skin was geometrically compensated with another area of preserved skin.

Results: The mean age of the patients was 52.88 ± 12.14 years. Mean pathological tumor size was 43.82 ± 31.39 mm. There were 7 (41.18%) locally advanced tumors. Six patients (35.29%) were submitted to neoadjuvant and the remainder to adjuvant chemotherapy. Radiotherapy was indicated in all cases. Fifteen patients (88.24%) received hormone therapy. Ptosis was corrected in all cases. The aesthetic result was rated excellent in seven cases (41.18%), good in 7 (41.18%), and fair in three cases (17.65%). Surgical margins were free. A seroma developed in one case (5.88%), small fat necrosis in three (17.65%), and enlarged scar in one (5.88%). There were no recurrences within 28.24 ± 18.02 months.

Conclusions: The technique allowed breast conservation in situations requiring large resection of affected skin, with free surgical margins, correction of ptosis, satisfactory symmetry, and few complications.