Fig 1.
Two representative cases of breast deformity after extensive excisions in the upper inner quadrant.
Fig 2.
Patients were divided into either the non-donut or donut group, depending on the distance between the tumor and NAC.
(A, B) A representative case of the non-donut group. The tumor was located 3 cm away from NAC. The patient underwent matrix rotation without de-epithelialization. The specimen measured 10 × 7.5 cm and weighed 126 g. (C, D) Patient with a tumor located at the 10 o’clock position underwent matrix rotation with de-epithelialization. Preoperative drawing with postoperative scar. The specimen measured 7 × 4.5 cm and weighed 56 g.
Fig 3.
Surgical technique of the matrix rotation.
The non-donut method was employed for those tumors which could be resected by a reverse-triangular shaped en bloc resection with negative margins (A). A concave incision was made along the lateral border of the breast from the tumor site to the midaxillary line, followed by a small triangular-shaped incision in the axilla to facilitate lymph node management and subsequently flap advancement (B). For tumors located less than 3 cm away from NAC or if safety margins could not be obtained by non-donut en bloc resection (C), the donut method was used which involved periareolar de-epithelialization and en bloc resection in a rectangular shape (D and E).
Table 1.
Characteristics of the patients who underwent matrix rotation procedures.
Table 2.
Patient questionnaire results after oncoplastic breast-conserving surgery (n = 35; 1 patient was lost to follow-up).
Fig 4.
The long scars faded away.