Conservative treatment of lower pole breast cancers by bilateral mammoplasty and radiotherapy

Aims. This series analyses the results of conservative surgery for large lo wer pole breast cancers by lumpectomy associated with a bilateral remodelli ng mammoplasty, in order to avoid residual deformities. Methods. This retrospective study concerns 50 patients with a lower pole br east cancer treated between 1986 and 1996 by lumpectomy, mammoplasty and ir radiation. The contralateral breast was immediately made symmetrical in all cases. The mean tumour size was 32.5 mm. Results. The mean weight of the lumpectomy specimen was 270 g. Resection ma rgins were tumour-free in 90% of cases. The main complication observed was delayed healing, thus postponing post-operative treatment in 6.5% of cases. The median follow-up was 48 months. The fi-year actuarial ipsilateral loca l recurrence rate was 7% and 5-year actuarial metastasis-free and overall s urvival rates were 81 and 97%, respectively. Cosmesis was satisfactory in 8 5% of patients. We observed better results when radiotherapy was performed after rather than prior to surgery (92 vs. 67%: NS). Conclusions. Performing a bilateral mammoplasty at the time of initial surg ery for large breast cancers situated in the lower quadrants of the breast facilitates larger lumpectomies with good cosmetic results.