[Conservative treatment of breast carcinoma in small breasts: new minimally invasive surgical technique].

Abstract

To achieve satisfactory cosmetic results after breast conserving treatment (BCT) of cancer in patients (with small breasts, the association of BCT and bilateral video-assisted augmentation mammoplasty with differentiated prosthesis volume was performed. From January 2001 21 small breast pts with breast cancer (stage T1N0M0) were treated with BCT and immediate trans-axillary video-assisted breast reconstruction with differentiated volumes. In 15 patients sentinel node biopsy was performed and 6 patients required total axillary dissection. Tumor-free margins were confirmed by histological examination. All patients underwent postoperative radiotherapy. Cosmetic results were evaluated through 6 parameters: breast shape with and without underwear, symmetry, mobility, inframammary fold, tenderness. We observed 4 minor complications: seroma3, paresthesia and slight arm weakness. Mini-invasive surgical revision was required in 3 cases due to scar retraction of the prosthesis pocket. Prosthesis volume resulted 30% (range, 0-47%) higher in the affected side. Cosmetic result was positive in 85% of cases (excellent 15%, good 45%, fair 25%). Trans-axillary video-assisted breast mammoplasty with differentiated prosthesis volumes allows to obtain good aesthetic results in small breast patients and to extend BCT indications with a low morbidity rate.