engleski

Omega ande inverted omega incisions - a concept of uniform incision in breast surgery

In the history of breast surgery, we have seen a lot of changes in orientation, position and localization of breast incisions. Most of the biopsy incisions have been made with no consideration of future mastectomy or reconstruction. Today wide acceptance of conservative breast surgery, skin-sparing mastectomy and reconstruction as an integral part of breast cancer therapy necessitates new consideration about the initial incisions used for breast biopsy. Patients and methods: During past two years we have preformed omega and inverted omega incision in 453 patients in different breast procedures: biopsy, lumpectomy, skin-sparing mastectoma(SSM) and skin and nipple-sparing mastectomy (SNSM). In 97% of patients that underwent SSM or SNSM, immediatereconstruction with autologous tissue was performed. Deepithelialized, pedicled latissimus dorsi flap and DIEP flap were used for reconstruction in majority of patients. Results: Using this type of incisions, seroma or hematomas have occured in 8% of lumpectomy cases, and 6% of SSM or SNSM cases, but only 1% needed surgical intervention. Infections were found in 1% of patients. About 15% of patients with SNSM showed partial thickness areolar necrosis, that healed spontaneously. patients have reported changes in nipple sensitivity in 5% of lumpectomy cases in the middle segment of the breast and in all cases where SNSM was performed. Untill now, we have had no full-thickness necrosis of the skin or nipples. Conclusions: Omega and inverted omega incisions are uniform incisions with good exposure of the breast or axilllary tissue, appropriate for different breast surgery procedures: biopsy, lumpectomy, SSM, SNSM, axillary dissection and all types of breast reconstruction. It avoids the "decollete" zone and preserves breast shape and projection.

omega and inverted omega incisions; breast surgery

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