The Effect of Oncoplastic Reduction Mammoplasty on the Incidence of Breast Lymphedema in Women Undergoing Breast Conservation Surgery.

[INTRODUCTION] Women with macromastia are susceptible to less favorable postoperative outcomes following breast conservation surgery (BCS). Among those, breast lymphedema is a severe complication that impacts functional and aesthetic outcomes. However, effective prevention strategies remain understudied. We aim to assess whether women with macromastia who receive oncoplastic reduction mammoplasty (ORM) have reduced incidence of postoperative breast lymphedema compared with patients who receive BCS alone.

[METHODS] A retrospective analysis of patients who underwent BCS alone or ORM followed by radiation was conducted. Demographics, treatment details, operative techniques, and postoperative outcomes were compared between BCS alone and ORM groups using inferential statistics. A subanalysis was similarly conducted to identify differences in postoperative outcomes between women with and without macromastia. Regression analysis was used to evaluate the effects of ORM and the factors associated with breast lymphedema.

[RESULTS] The overall incidence of breast lymphedema was 10.6%. Black race, preoperative breast volume ≥ 1500 cm, axillary lymph node dissection at time of surgery, incidence of cellulitis, and incidence of arm lymphedema were positively associated with breast lymphedema rate. Regression analysis demonstrated that women with breast volumes ≥ 1500 cm who underwent BCS alone were 6.575 times more likely to develop breast lymphedema than patients who underwent ORM (p = 0.014).

[CONCLUSIONS] Women with macromastia who receive BCS alone have an increased incidence of postoperative breast lymphedema. Oncoplastic reduction mammoplasty is an alternative treatment option that reduces the likelihood of postoperative breast lymphedema compared with BCS alone in patients with breast volumes ≥ 1500 cm.