Reduction Mammoplasty as an Oncoplastic Tool for Treatment of Early Stages of Breast Cancer

Abstract

The mammary gland is everything contained within the cutaneous envelope of the breast, consists, in proportions varying from one woman to another and at the different stages of reproductive life, of glandular tissue proper, connective tissue and adipose tissue. The adult breast lies between the second and sixth ribs in the vertical plane and between the sternal edge medially and mid- axillary line laterally .The average breast measures 10-12 cm in diameter, and thickness centrally is 5-7 cm. It is concentric with a lateral projection into the axilla, referred to as the axillary tail of Spence. The female breasts constitute one of the most important body organs. Besides their physiological role during the nursing period, they play a vital role in women’s sexuality, confidence and body proportions. So it is not surprising that aesthetic breast surgery is one of the most common procedures performed today. Breast cancer is the most common cancer in women worldwide. Approximately 1.15 million cases were recorded in 2002, representing 23% of all female and 11% of overall cancers. Incidence rates for 2002 vary internationally by more than 25-fold, ranging from 3.9 cases in Mozambique to 101.1 cases per 100,000 women in the United States. Overall, breast cancer accounts for ~16% of all cancer deaths in adult women. Survival rates range from more than 90% to less than 50%, depending on the characteristics of the tumor, its size and spread, and the availability of treatment. Average 5-year survival rates range from ∼73 to ∼57%, respectively, in high and in middle- to low-income countries. Large regional disparities in mortality rates probably reflect significant disparities in detection and management programs. Early breast cancer does not usually cause pain when the cancer grows; it causes changes in the size or shape of the breast: a lump or thickening may be noticeable. In advanced cases the tumor can show signs of ulceration of the skin and fixation to the chest wall and in the worst cases large lymph nodes may be present. Breast cancer can often be detected at early stages through mammography screening. The adequate follow-up of women with a positive result could significantly reduce mortality. Surgery is the main line of treatment of breast cancer because surgery aims to achieve loco regional control of the disease, pathological evaluation of resected tissue which informs decisions regarding adjuvant local and systemic therapy. Surgeons who treat breast cancer strive to perform operations that are aesthetically pleasing without compromising oncologic outcome. Patients are more informed than ever and are encouraging their surgical teams to continue to evolve.