Experience with reduction mammaplasty combined with breast conservation therapy in the treatment of XXXX .

@entity1 @entity0 @entity4182 @entity39 @entity5 @entity1410 @entity21879 @entity3 @entity204
As the inclusion criteria for breast conservation therapy have continued to evolve to include @entity5 , very large breasts, and central @entity5 , the potential for significant disfigurement after breast conservation therapy has also increased. This has led some centers to develop coordinated oncology-plastic surgery approaches to ensure both adequate @entity5 resection and aesthetic appearance to the breasts. The authors applied this principle to a specific group of @entity0 @entity1 -- @entity1 with @entity21879 --who would benefit from reduction mammaplasty. Eleven @entity1 were identified from the senior author's (S.L.S.) reconstructive practice who underwent breast conservation therapy followed by breast reconfiguration and bilateral reduction mammaplasty. Preoperative brassiere sizes ranged from 34D to 46D. All @entity1 had immediate reduction after frozen sections from the lumpectomy/partial mastectomy margins were determined to be negative. A total of 22 reduction mammaplasties were performed (eight free-nipple grafts, five inferior pedicle flaps, seven superomedial pedicle flaps, and two superolateral flaps) and an average of 1085 g was removed per breast. All @entity1 underwent radiation therapy postoperatively. There were eight minor complications in six @entity1 (one @entity1410 , one keloid, one radiation burn, two cases of @entity4182 , and three cases of fat @entity39 ). After an average of 24 months' follow-up, there were no local recurrences and one @entity204 from distant @entity3 . Seven of the 11 @entity1 were available and agreed to rate their aesthetic satisfaction on the basis of a scale from 1 to 4, with 4 being the best. The mean satisfaction score was 3.3. Aesthetic outcomes before radiation therapy and after radiation therapy were evaluated by a panel of plastic surgery residents blinded to the purpose of the study. Using a scale of 1 to 4, the aesthetic mean before radiation therapy was 2.9 and the aesthetic mean after radiation therapy was 3.03. By combining breast conservation therapy with breast reconfiguration or reduction in large-breasted @entity1 , multiple benefits are derived. Larger segmental or partial mastectomies can be performed without disfigurement risk, ensuring adequate surgical margins. Immediate reconfiguration of the breast with reduction of the contralateral side creates symmetric, aesthetically pleasing breasts; allows contralateral breast tissue to be evaluated; and spares @entity1 from undergoing a second operative procedure. Such a coordinated program gives @entity1 an important boost, both physically and psychologically, during management of their @entity0 .
