Breast-conserving surgery using an inframammary fold incision technique for breast cancer

Abstract

Background: Breast-conserving surgery is an established alternative for the majority of women with early stage breast cancer. Consensus on negative margins (no ink on tumour) for invasive cancer makes mutilating extensive lumpectomies unnecessary. Several breast-conserving surgical methods are described in the literature. The aim of this study was to describe and evaluate a technique using the inframammary fold incision.

Methods: Twenty-seven patients with suspected breast cancer (stage I–II) underwent breast-conserving surgery using the inframammary fold incision. Data regarding tumour characteristics, margin status, complications, oncologic and aesthetic outcome was analysed retrospectively.

Results: After a median follow-up of 35 months, 23 of the 24 patients with breast cancer (95.8%) had no evidence of disease. Post-operative complications (as defined by infection requiring antibiotic treatment and/or seroma requiring drainage) were seen in three of the 27 patients (11.1%). The final pathological examination revealed a positive excision margin in four patients (16.7%). Post-operative evaluation with the BREAST-Q™ BCT module showed a mean RASCH score of 72.5 regarding ‘Satisfaction with breast’. The aesthetic result with a hidden scar is exemplified.

Conclusion: Breast-conserving surgery using the inframammary fold incision seems to be a safe method with better cosmesis; however, further research is needed.

Keywords:

• Breast cancer
• breast-conserving surgery
• inframammary fold incision

Acknowledgements

The authors thank: Helena Setterberg, Linnéa Axelsson, and Ann-Chatrin Edvinsson, Surgical Breast Clinical Nurse Specialists, Department of Surgery at Skaraborgs Hospital, Skövde and Department of Plastic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden; Niclas Löfgren, Medical Photographer, Department of Plastic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden; and Erik Bülow, Statistician, Regional Cancer Center (West), Western Sweden Health Care Region, Sweden.

Disclosure statement

The authors report no conflicts of interest, financial or non-financial. This study was funded by Sahlgrenska University Hospital. The study sponsors had no involvement in the study design or collection, analysis and interpretation of data.