Breast cancer in the inframammary fold: is preserving the inframammary fold during mastectomy justified?

Introduction: Preservation of the inframammary fold (IMF) during mastectomy facilitates breast reconstruction. The true incidence of breast cancer in the IMF is not well known. We report our experience of this condition. Methods: The site and clinical features of initial presentation and recurrence of breast cancer within the breast in a consecutive series of 580 patients between 1997 and 2000 was studied. Results: Primary breast tumours were detected within the IMF in four patients (0.7%). Only two tumours presenting within the IMF were visible on mammography. During the follow-up period, there were five patients with local recurrences involving either breast or skin flaps, but no breast cancer recurrence was observed in the IMF. Conclusion: Tumours within the IMF are rare but its occasional occurrence requires reconsideration of the safety of preserving the IMF at mastectomy.