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Journal of Breast Disease > Volume 8(1); 2020 > Article
Journal of Breast Disease 2020;8(1): 37-42. doi: https://doi.org/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
Seong Jun Lim, M.D., Hee Jeong Kim, M.D., Ph.D., Il Young Chung, M.D., Ph.D., Ji Sun Kim, M.D., Ph.D., Sae Byul Lee, M.D., Ph.D., Jong Won Lee, M.D., Ph.D., Byung Ho Son, M.D., Ph.D., Sei Hyun Ahn, M.D., Ph.D., Hak Hee Kim, M.D., Ph.D.1, Sung-Bae Kim, M.D., Ph.D.2, Gyung-Yub Gong, M.D., Ph.D.3, Beom Seok Ko, M.D., Ph.D.
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
1Departement of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
2Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
3Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Corresponding Author: Beom Seok Ko ,Tel: +82-2-3010-3510, Fax: +82-2-474-9027, Email: spdoctorko@gmail.com
Received: October 17, 2019    Revised: November 18, 2019    Accepted: February 18, 2020
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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.
Conclusions: 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.
Keywords: Margins of excision | Segmental mastectomy | Surgical wound
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