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ORIGINAL RESEARCH article

Front. Surg.

Sec. Reconstructive and Plastic Surgery

Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1623894

This article is part of the Research TopicExploring Precision Medicine in Reconstructive and Aesthetic SurgeryView all articles

Ultrasound (US) -assisted periareolar oncoplastic approach in breast surgery: a focus on surgical technique

Provisionally accepted
  • 1Department of Surgery, Sapienza University of Rome, Rome, Italy
  • 2Breast Center, Azienda Ospedaliera San Giovanni-Addolorata, roma, Italy
  • 33 Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
  • 4Plastic and Reconstructive Surgery Unit, Centre Hospitalier Universitaire Bichat Claude-Bernard., Paris, France
  • 5Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy

The final, formatted version of the article will be published soon.

Breast conservation surgery (BCS) combined with post-operative radiotherapy is the standard and preferred treatment for early-stage breast cancer (eBC), offering survival outcomes comparable to mastectomy while improving body image and quality of life. Oncoplastic breast surgery (OBS) has evolved from BCS to allow more extensive tissue removal while maintaining oncological safety and reducing the risk of post-surgical deformities. The ultrasound (US)-assisted periareolar approach in breast surgery offers several potential benefits, including reduced scarring, improved cosmetic outcomes, and enhanced surgical precision, particularly for non-palpable or small lesions, and potentially better nipple sensation preservation. This study aim to describe an US-assisted periareolar OBS approach for eBC patients with small to moderate breast ptosis. Methods Here we present a focus on surgical technique consisting in OBS combining a US-assisted periareolar approach with volume displacement in small- to moderate- ptosic breasts. Margin resection adequacy, surgical complications and patient satisfaction using the Breast-Q questionnaire were assessed. Results Thirty-two patients were considered. A negative margin of excision was achieved in all cases, and patients routinely received post-operative hypofractionated radiotherapy. Seroma was the most common complication (12.5%), while breast fat necrosis and minor wound infections occurred in 6% and 3% of cases, respectively. At a median follow-up of 12 months (range 6-18), post-treatment breast retraction occurred in 3 patients (9%), all of whom underwent fat grafting to improve outcomes. The average satisfaction score as determined by Breast-Q module was 78.6, rising to 81.3 for those who underwent contralateral mammaplasty. Conclusions The combination of imaging, the use of oncoplastic surgical techniques and an appropriate post-operative management may provide the surgeon new tools for the treatment of eBC. In selected cases, the US-assisted periareolar oncoplastic approach is a versatile technique that can be easily adapted for tumors in any location of the breast.

Keywords: breast cancer, oncoplastic breast surgery, Breast conservative surgery, breast ultrasound, Patient Satisfaction, Aesthetic outcome

Received: 06 May 2025; Accepted: 05 Aug 2025.

Copyright: © 2025 De Luca, Tripodi, Fortunato, Pediconi, Cannistra, Rocco, Vergine and Amabile. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Alessandro De Luca, Department of Surgery, Sapienza University of Rome, Rome, Italy

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