An oncoplastic breast surgeon is planning a therapeutic mammoplasty for a 52-year-old woman with a 3 cm upper outer quadrant cancer in a large-breasted patient (cup size F). The planned excision will remove 35% of breast volume. According to oncoplastic surgery principles, what level (volume replacement vs. volume displacement) of oncoplastic procedure best suits this case?

• A Level 2 volume displacement — therapeutic mammoplasty with reduction technique ✓
• B Level 1 volume displacement — simple local tissue advancement
• C Level 2 volume replacement — myocutaneous flap from latissimus dorsi
• D Level 1 volume replacement — local perforator flap

Explanation

Volume displacement techniques use the remaining breast tissue to fill the defect; they are suitable when excising up to 50% of breast volume in patients with large or ptotic breasts. Level 2 displacement refers to therapeutic mammoplasty with reduction or mastopexy techniques, appropriate for large-breasted patients where significant volume is removed. Volume replacement (importing tissue from outside the breast) is reserved for patients with small breasts where displacement would cause major deformity.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.