A Quadrant-based Algorithm for Oncoplastic Breast Reduction: The Use of Mirror Flaps for Filling Superior Pole...

Area of Science:

• Oncoplastic surgery
• Breast reconstruction techniques
• Surgical oncology

Background:

• Reconstructing upper-quadrant defects in oncoplastic breast reduction (OBR) presents challenges due to potential concavity after tumor resection.
• A novel dual-component technique using superiorly based and inferior advancement flaps was developed to address these specific defect locations.
• This approach aims to mirror the laterality of the lumpectomy defect for improved aesthetic outcomes.

Purpose of the Study:

• To evaluate the outcomes of a dual-component mirror flap technique for superior pole reconstruction in oncoplastic breast reduction.
• To assess the efficacy and complication rates associated with this specific surgical algorithm.
• To determine the technique's ability to prevent or minimize upper-pole concavity.

Main Methods:

• A retrospective review of 47 patients (51 breasts) undergoing oncoplastic breast reduction by a single surgeon between September 2022 and November 2024.
• Application of a dual-component technique involving a superiorly based flap for the nipple-areola complex (NAC) and an inferior advancement flap for volume displacement.
• Tumor locations predominantly in the upper outer quadrant (UOQ) and upper inner quadrant (UIQ) were addressed with specific flap orientations.

Main Results:

• The majority of tumors were in the upper outer quadrant (70.6%) and upper inner quadrant (29.4%).
• Over a follow-up of 13.2 ± 7.5 months, 15.7% of breasts experienced complications.
• A low rate of upper-pole concavity (2.0%) was observed, with minor revisions needed for radiation-related issues or dehiscence.

Conclusions:

• The dual-component mirror flap technique provides a reliable method for reconstructing superior quadrant defects in oncoplastic breast reduction.
• This approach demonstrates a low incidence of contour deformities, offering a favorable aesthetic outcome.
• The technique effectively addresses challenges associated with upper-pole concavity following tumor resection.