Management of central breast tumours with immediate reconstruction of the nipple-areola complex; a suggested guide

Background: Breast conserving surgery (BCS) for central breast tumours with immediate reconstruction of the nipple-areola complex (NAC) is a relatively new addition to the surgical palette of the oncoplastic surgeon. Most oncoplastic techniques presented to date have only been suitable for women with large breasts. Methods: From 2012 to 2013, a series of eligible women with central breast cancers were treated with BCS and NAC reconstruction. According to breast size and shape, three different procedures were performed. Results: 20 women were operated, 13 by breast reduction techniques and 7 by anterior intercostal perforator flaps (AICAP flaps). Overall cosmetic results were good to excellent for breast shape, symmetry and neo-nipple projection. Conclusion: We present a guideline for selecting the best available surgical technique for immediate NAC reconstruction in women with any breast type, size or shape and describe a new replacement technique using a local perforator flap. (C) 2014 Elsevier Ltd. All rights reserved.