Postquadrantectomy breast deformities: classification and techniques of surgical correction.

Area of Science:

• Plastic Surgery
• Oncology
• Radiotherapy

Background:

• Assessing cosmetic outcomes after breast-conserving surgery (quadrantectomy, segmentectomy, partial mastectomy) and radiation therapy is challenging due to subjective variability.
• Objective evaluation of post-surgical breast deformities is needed to guide reconstructive strategies.

Observation:

• A study of 54 patients (1979-1983) identified and classified four types of cosmetic deformities following these procedures.
• Type I: Nipple-areola complex malposition/distortion from fibrosis and scar contracture.
• Type II: Localized tissue insufficiency (skin, subcutaneous, or both). Type III: Breast retraction/shrinkage from radiotherapy effects on parenchyma.
• Type IV: Severe radiation damage to skin, nipple-areola complex, and underlying tissues.

Findings:

• Four distinct types of breast deformities were identified based on morphologic criteria and etiopathologic factors.
• Specific causes linked to each deformity type, including fibrosis, scar contracture, tissue deficiency, and radiation effects.
• Surgical correction strategies for each deformity type were discussed.

Implications:

• Provides a classification system for objective evaluation of post-mastectomy cosmetic deformities.
• Informs surgical planning for breast reconstruction after conservative breast cancer treatments.
• Highlights the distinct etiologies of deformities, guiding tailored reconstructive approaches.