Feasibility and Safety of Oncoplastic Breast-Conserving Surgery Through an Inframammary Incision

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Abstract Background: Breast-conserving therapy (BCT) became the treatment of choice for early breast cancer due to a better understanding of the disease's biological activity and natural history. With the addition of oncoplastic breast surgery (OPS), conservation could be conducted in relatively large tumors with the best possible cosmetic results and without jeopardizing oncological safety. OPS procedures are by incising the skin envelop of the breast then dissection of the dermoglandular breast tissue. An inframammary crease incision is a suitable choice as a hidden scar in the breast envelope because one of the primary considerations for good oncoplastic methods is the cosmetic outcome. It also provides easy access to the retromammary region. This study aims to assess the feasibility of adopting the retro glandular approach for breast-conserving surgery by making a skin incision in the inframammary fold (IMF)Patients and methods: This study involved 67 female patients with breast cancer who were candidates for BCS and had tumors deeply seated between January 2019 and July 2021. An incision is made in the inframammary fold, its length depends on the tumor site, the tumor was excised after retroglandular exploration. Reapproximation of the glandular pillars was done and the wound was closed after a closed suction drain was inserted. SPSS software package version 20.0 was used for statistical analysis.Results: All patients were presented with mass, most of them (53.7%) had breast cup size B. 55.3% of cases had their tumor in the lower half of the breast. The median operative time was 125 (110 – 140) minutes. Seroma was the most common complication (8.9% of cases). 62.7% of cases had excellent results as judged by breast surgeons other than the operating surgeon. 82.1% of patients were satisfied with the aesthetic results.Conclusion:The Inframammary approach for breast-conserving surgery is feasible and safe for surgical treatment of patients presented with deeply seated breast cancer.Trial registration: This study protocol was reviewed and approved by the Ethical Committee of Alexandria Faculty of Medicine on 16- 7- 2020. Approval number: 0106451.

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