Importance of breast biopsy incision in final outcome of breast reconstruction

Currently, breast cancer is one of the most common malignant lesions among women in North America--it occurs in one in every nine such women. Approximately 180,000 cases will be diagnosed this year. During the past 3 years at the Mayo Clinic, approximately 4,000 breast biopsies were performed. In approximately 20% of such biopsy specimens, a malignant lesion will be identified. Surgeons should be aware of the current possibilities in breast reconstruction and should consider the cosmetic result in the placement of breast biopsy incisions. Even lesions in the superior or inferior portions of the breast are accessible through generous periareolar incisions. The biopsy incision should be within the confines of a possible skin excision for mastectomy to avoid creating two scars if the specimen proves cancerous. The choice of site for the biopsy incision, however, should never jeopardize the treatment of the cancer. Appropriate preoperative planning will ensure optimal cosmetic and therapeutic results in the management of breast lesions.