Partial mastectomy and breast reduction as a valuable treatment option for patients with macromastia and carcinoma of the breast.

The essential goals of every reconstructive procedure of the breast are to create a breast mound and establish symmetry. Breast conservation operation is now a widely accepted treatment for carcinoma of the breast. Four patients who presented with macromastia or mammary hypertrophy and a simultaneous carcinoma of the breast were treated by combined partial mastectomy and bilateral breast reduction. Incisions on the breast were made using standard Wise pattern (keyhole) markings. In each instance, the tumor was removed with a generous margin of normal surrounding mammary tissue. Two procedures used the inferior pedicle technique and two were done by resection and transplantation of the nipple. The average mammary tissue resection was 825 grams. All incisions healed primarily and necessary adjuvant chemoradiation was not delayed. Each patient is alive and well without evidence of disease with a follow-up period ranging from seven to 43 months. Postoperatively, the appearance of the breast is esthetically improved and all symptoms related to macromastia have resolved. Advantages of combining these two techniques include improved symmetry, easier postoperative self-examination of the breast and decreased radiation effect noted with larger breasts. Postoperative mammograms have been useful for patient follow-up evaluation. Combined segmental mastectomy and breast reduction represents a valuable treatment option for the patient who presents with macromastia and carcinoma of the breast. The carcinoma ablative procedure is not compromised and the improved symmetry of the breast has resulted in an excellent cosmetic outcome in these patients.