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Preservation of the inframammary fold: what are we leaving behind?
G W Carlson1, N Grossl, M M Lewis
1Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
Insights
Preserving the inframammary fold (IMF) during mastectomy for breast cancer leaves minimal breast tissue, ensuring complete cancer removal. This technique supports immediate breast reconstruction without compromising oncologic safety.
Area of Science:
- Oncology
- Plastic Surgery
- Breast Surgery
Background:
- The inframammary fold (IMF) is crucial for immediate breast reconstruction post-mastectomy.
- Assessing residual breast tissue in the IMF is vital for oncologic safety.
Purpose of the Study:
- To histologically evaluate the amount of breast tissue within preserved inframammary fold specimens.
- To determine if IMF preservation impacts mastectomy completeness.
Main Methods:
- Twenty-four inframammary fold specimens were collected after mastectomy.
- Serial sectioning and histological examination were performed.
- Computer image analysis quantified breast tissue percentage.
Main Results:
- Mean IMF tissue volume was 99 cm³.
- Breast tissue was present in 13 of 24 specimens (54.2%).
- The mean percentage of breast tissue was minimal (0.04% in positive specimens, 0.02% overall).
Conclusions:
- Preserving the inframammary fold results in minimal residual breast tissue.
- IMF preservation does not compromise the completeness of mastectomy for breast cancer.
- This approach is oncologically safe and facilitates immediate breast reconstruction.
Abstract:
Preservation of the inframammary fold (IMF) at the time of mastectomy facilitates immediate breast reconstruction. Twenty-four IMF specimens were removed separately after mastectomy for cancer, were serially sectioned, and were examined histologically. Computer image analysis was used to calculate the percentage of breast tissue in each specimen. The mean volume of IMF tissue removed was 99 cm3 (27.3-205.2 cm3), and the mean area examined histologically was 3,036.3 mm2 (294-11,755 mm2). Breast tissue was identified in 13 of the 24 specimens. All cases were negative for carcinoma, but one case had a focus of ductal hyperplasia, usual type. The mean percent breast tissue in those positive for breast tissue was 0.04 percent and 0.02 percent overall. Preservation of the IMF leaves a minimal amount of breast tissue and does not appreciably effect the completeness of a mastectomy.