Treatment of inferior pole breast cancer with the oncoplastic 'Crescent' technique: the Westmead experience.

BACKGROUND: Conservative treatment of inferior breast cancers has been a challenge for breast surgeons due to the high incidence of poor cosmetic outcomes. In 2008, Renouvel et al. described an oncoplastic 'Crescent' technique utilizing an advancement flap to fill the defect after cancer excision in the lower pole of the breast. A follow-up study demonstrated no local recurrence at 45 months and excellent or good cosmetic outcomes in over 70% of patients. This study aims to assess the outcomes of applying this 'Crescent' technique in a breast surgical unit.

METHODS: Retrospective study carried out at Westmead Breast Cancer Institute on 16 patients treated with the 'Crescent' technique. Data regarding patient and tumour characteristics, operative outcomes and complications were obtained. Patients were invited to complete a modified Breast-Q questionnaire and have their photographs taken to assess patient satisfaction and cosmetic outcome.

RESULTS: Over 12 months, 16 women underwent the 'Crescent' technique. Mean tumour size was 11.4 mm (range 2.0-36 mm) and median resected volume was 33.0 g (range 15-117 g). One patient (7.1%) had involved margins. One patient returned to theatre for evacuation of a haematoma. Cosmetic outcome was excellent or good in over 80% of patients.

CONCLUSION: The oncoplastic 'Crescent' technique is a safe and reliable technique with good cosmetic outcome that can be implemented in a breast surgical unit.