# The Sparrow (Modified Lazy-S) Incision: A Practical Alternative to Level 1 Oncoplastic Techniques in Breast-Conserving Surgery

## TL;DR

The Sparrow incision is a new surgical technique for breast-conserving surgery that offers safety and good patient satisfaction without requiring extra training.

## Contribution

The Sparrow (Modified Lazy-S) incision is introduced as a practical alternative to level 1 oncoplastic techniques in breast-conserving surgery.

## Key findings

- The Sparrow incision had an 8.8% complication rate, consistent with prior reports.
- Patients reported high satisfaction with breast shape, symmetry, and psychosocial well-being.
- The technique is oncologically safe and does not prolong surgery or require special tools.

## Abstract

Background: The Sparrow (Modified Lazy-S) incision was developed as an alternative to the level 1 oncoplastic approach in breast-conserving surgery. Unlike the standard Lazy-S incision, both ends are more curved, a central skin islet is preserved, and the incision can be safely applied in all four breast quadrants, either horizontally or vertically. Large anterior skin islets facilitate the safe excision of tumors located near the skin, thereby reducing the risk of positive anterior margins. This technique is straightforward and does not require specialized training. Methods: Patients with invasive carcinoma who underwent breast-conserving surgery using the Sparrow incision at Istanbul University-Cerrahpasa Breast Clinic between January 2017 and January 2020 were retrospectively screened. Results: All 57 patients underwent the Sparrow incision. The overall complication rate was 8.8%, consistent with previously reported rates (9.8–10.97%). Patient-reported outcomes, assessed using Breast-Q™ modules, demonstrated high levels of satisfaction in terms of breast shape, symmetry, and psychosocial well-being. Conclusions: The Sparrow incision is an oncologically safe technique with potential advantages, as it does not prolong operative time or require additional instruments. It permits excision of previous biopsy sites and can be applied in patients undergoing neoadjuvant therapy or presenting with multifocal tumors. Patient-reported outcomes suggest favorable esthetic and psychosocial results.