Oncoplastic Conservative Surgeries Versus Reconstructive Breast Surgeries in Large Breasted Women with Breast Cancer

Introduction: The choice for a special method of reconstruction is multifactorial and should consider patient preference and comorbidities. Therapeutic mammoplasty and extended latissimus dorsi flap following subcutaneous mastectomy are considered good options for reshaping large breasts after mastectomy. In this study, we compare the patient satisfaction and aesthetic outcome for both techniques applied for patients with large breasts having breast cancer. Patients and Methods: This study is a prospective clinical trial done from June 2012 to octobor 2014 in both Surgical Oncology Unit in Mansoura Oncology Center, Mansoura University. We enrolled 40 patients of large breasted women with breast cancer. Patients were counseled for either conservative oncoplastic therapeutic mammoplasty surgery or subcutaneous mastectomy with immediate autogenous reconstructive surgery using extended latismus dorsi based on the oncologic eligibility for each procedure. Results: Mean healing time for the mammoplasty group was (18.8 days) longer than the latissimus group (16.4). Regarding cosmetic result of the latismus group, the mean for breast size, shape, texture, symmetry and scar appearance were 3.8, 3.6, 4.1, 3.6 and 3.5 respectively. This showed to be inferior to the results of the mammoplasty group (4.5, 4.3, 4.2, 3.7 and 4. 1). Regarding the cosmetic result of the latissimus group, the mean for breast size, shape, texture, symmetry and scar appearance were 3.8, 3.6, 4.1, 3.6 and 3.5 respectively. This showed to be inferior to the results of the mammoplasty group (4.5, 4.3, 4.2, 3.7 and 4. 1). Conclusion: Though the complications, therapeutic mammoplasty for mastectomy remains an ideal choice for a cosmetic outcome of very large cup sized and ptotic breasts that need significant skin flap reduction.