An Innovative Approach for Breast Conservation in a Patient With Multicentric Upper Inner and Central Quadrant Breast Tumors

TL;DR

This paper presents a successful breast-conserving surgery for a patient with tumors in multiple areas of the breast, avoiding mastectomy.

Contribution

A novel surgical technique combining wide excision and MICAP flap for central and upper inner quadrant tumors is described.

Findings

The patient achieved a satisfactory cosmetic outcome after the procedure.

The patient remains disease-free 15 months post-surgery.

The technique demonstrates the feasibility of breast conservation in complex tumor cases.

Abstract

Oncoplastic breast surgery expands the number of options for conservative breast cancer treatment. Traditionally, patients with multicentric tumors, especially those in the upper and central quadrant, were offered mastectomy. Recent evidence supports the safety and feasibility of breast conservation surgery even in patients with multifocal and multicentric breast cancer. However, there remains a challenge to achieve wide local excision of tumors while maintaining a good cosmetic outcome, especially in central and upper inner quadrant tumors.

Here, we present a case where a patient with multicentric upper inner and central quadrant tumors was managed with breast-conserving surgery: wire bracketing of the lesions with wide local excision with nipple-areolar complex, followed by volume replacement and areolar reconstruction with medial intercostal artery perforator (MICAP) flap. The patient had a satisfactory cosmetic outcome with no complications. She continues to be disease-free and satisfied with the postoperative result at 15 months post operation.

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