J Breast Dis.  2020 Jun;8(1):37-42. 10.14449/jbd.2020.8.1.37.

The Usefulness of Periareolar Zigzag Incision in Breast Conserving-Surgery in Breast Cancer Patients: Experience in a Single Institution

• Lim SJ
• Kim HJ
• Chung IY
• Kim JS
• Lee SB
• Lee JW
• Son BH
• Ahn SH
• Kim HH
• Kim SB
• Gong GY
• Ko BS

• KMID: 2504519
• DOI: http://doi.org/10.14449/jbd.2020.8.1.37

Abstract

Purpose
Various incision techniques have been used in breast-conserving surgery (BCS) to reduce scar formation, including the frequently used periareolar incision technique. However, its applicability in removing large-size tumors or those distant from the nipple has remained limited. We performed periareolar zigzag (P-Z) incision to address these problems in BCS and to improve cosmetic outcomes.
Methods
Patients who underwent P-Z incision in BCS between January 2016 and November 2017 were retrospectively analyzed in terms of clinicopathological features and surgical findings. Factors affecting the positive margin were analyzed.
Results
A total of 305 patients were reviewed. The patients presented with a median age of 51 years, mean tumor size 1.9 cm, and mean tumor distance of 3.3 cm from the nipple. Intraoperative frozen biopsy and final pathologic findings showed 43 (14.1%) and 7 (2.3%) tumor-positive margins. There were no major complications associated with the surgery, and no re-operations were required due to bleeding or other reasons.
Conclusion
The P-Z incision technique was used to achieve sufficient operative field during BCS, and large tumors or those distant from the nipple could be removed without any complications. This technique is considered an oncologically safe surgical technique resulting in good cosmetic outcomes.

Keyword

Margins of excision; Segmental mastectomy; Surgical wound