Oncoplastic Reconstruction of Lumpectomy Defects-Upper Outer Quadrant Split Reductions and IORT

Tumors of the upper outer quadrant of the breast and with certain characteristics can be excised with lumpectomy, intra-operative radiation therapy, and oncoplastic reconstruction of the lumpectomy defect. In general, tumors that are amenable to lumpectomy and IORT tend to be less than 3 cm, estrogen receptor positive, unifocal, and have negative lymph node status. When a breast undergoes a lumpectomy and intraoperative radiation therapy, the changes to the breast and surrounding skin tend to be less than whole breast radiation. Furthermore, a breast that has undergone lumpectomy and requires whole breast radiation, will tolerate radiation much better than a breast that has undergone a mastectomy. It is important to keep protein intake high in the peri-operative period as this facilitates wound healing. In those patients who undergo whole breast radiation, it is important to take daily care of the skin with Miaderm. We have also had patients who have tolerated radiation well who have used aloe vera to prevent and facilitate healing of blisters secondary to radiation therapy. Daily skin care and protein intake is helpful for wound healing.