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Omega Pattern Breast Reduction: A Unique Approach to Reducing the Radiated Breast
Alap U. Patel, BA, Kathryn E. Skibba, MD, Marilyn N. Ling, MD, Ashley N. Amalfi, MD.
University of Rochester Medical Center, Rochester, NY, USA.

BACKGROUND: Breast reduction in a previously irradiated breast can be technically difficult with high morbidity due to irreversible changes in skin and tissue. While generally successful, surgical reduction of irradiated breasts should be approached with caution. An omega pattern, by way of a central incision, is an advantageous approach to breast reduction after radiation because it avoids significant flap undermining and minimally risks blood supply to the nipple-areola complex (NAC). The purpose of our study is to evaluate the safety and efficacy of the omega pattern breast reduction technique in patients with previous breast irradiation. METHODS: Retrospective review of all omega pattern breast reductions between 2016-2019 was done. Data was obtained on patient demographics, reduction pattern, specimen weight, and major/minor complications. RESULTS: Between 2016-2019, eight patients underwent an omega pattern reduction mammoplasty on their irradiated breast. All had completed their radiation therapy at least 12 months prior to their reduction surgery. Patients had a mean BMI of 30.4 (SD 5.78). 100% of patients had partial mastectomy for invasive ductal carcinoma. Chemotherapy was necessary in 63% of patients with a mean duration of 3.25 months (SD 0.5), and 75% had hormonal therapy for an average duration of 3.83 years (SD 1.83). The average time between radiation and omega reduction was 6.13 years (SD 4.45). 100% of patients had complete breast radiation. The average radiation dose was 4920 centigrays (cGy) (SD 214). Sixty-three percent of our patients underwent an Omega Pattern Reduction Mammoplasty on their left breast and 37% on the right. On the contralateral breast, 88% underwent a wise pattern skin resection, and 12% vertical. In these contralateral breasts, 67% were based on an inferior pedicle, and 33% on a superiormedial. The average radiated breast reduction weight was 222 g (SD 212, range 9-458), and on the non-radiated breast was 426 g (SD 374, range 41-1197). No patients suffered major complications; two patients had minor complications: one with contact dermatitis and one with infected fat necrosis and delayed healing CONCLUSIONS: The omega pattern breast reduction allows for a safe and technically effective method of reduction mammoplasty in irradiated breasts. The author’s addition of NAC reduction is a safe adjunct to the procedure that furthers the resulting symmetry and aesthetic outcome of the procedure.


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