Breast partial amputation: a new option for oncologic breast-conserving surgery

Abstract

Introduction: Breast partial amputation (BPA) is a technique used in patients with gigantomastia and/or a suprasternal
notch-areola distance greater than 35 cm. It is infrequently used for breast cancer. Objective: This study aimed to review
BPA indications and its results in an oncologic hospital. Methods: This is a retrospective study of cases undergoing BPA
treatment since 2019 at a tertiary oncology hospital. The study was approved by the research ethics committee under
number 70454923.9.0000.5105. The BPA technique consists of breast resection with a linear incision close to the level of
the mammary fold and resection of all distal breast tissue, followed or not by areolar implants. In oncology, its main indication is for small or medium-sized breasts with extreme ptosis, big and heavy breasts, reducing breast volume, eliminating ptosis, optimizing the area for radiotherapy, and reducing irradiation of neighboring tissues. It is a modality in the
context of extreme oncoplasty. The characteristics and results of patients who underwent this procedure were examined.
Results: Ten institutional patients were reviewed; the procedures were generally performed on those with ptotic, nonvoluminous breasts, and in elderly patients. The surgery was associated with conservative treatment of the breast on the
tumor side (six patients), with the majority undergoing symmetrization (five patients). Another indication was for the symmetrization of those (two patients) who underwent mastectomy with prosthesis, or reduction of the contralateral ptotic
breast in patients undergoing mastectomy without reconstruction. No serious surgical complications were observed, and
the degree of satisfaction was high. Conclusion: BPA is an easy-to-mark and perform method for breast-conserving surgery. It represents a solution for ptotic, big, or heavy breasts. It is associated with low surgical complications, allowing a
reduction in the dose of radiotherapy in nearby organs, leading to a high degree of satisfaction