[Mammoplasty combined with irradiation: conservative treatment of breast cancer localized in the lower quadrant].

Conservative radio-surgical treatment of breast neoplasms is often responsible for poor cosmetic results when the tumor is located in the lower quadrants. Since 1986, ten patients with such a tumor were treated at the Curie Institute by a combination of a superior pedicle mammaplasty and radiotherapy. The mammaplasty was bilateral in nine cases. Four patients were operated upon before radiotherapy, while the six others had preoperative radiotherapy. The average weight of the lumpectomy was 193 g, and its margins were always tumor-free. There were no locoregional recurrences (average follow-up time: 16 months). Symmetrization enabled us to obtain contralateral histological data. The cosmetic results were very good when surgery was performed before radiotherapy. When radiotherapy was performed first, the result was often slightly asymmetric, with a smaller irradiated breast. The only complication was partial areolar necrosis in one patient who had been heavily irradiated (85 grays). The combination of a mammaplasty and radiotherapy makes it possible to perform a large lumpectomy of the lower quadrants with good cosmetic results. The interest of this protocol in the extension of the indications for conservative treatments of breast neoplasms is discussed.