Assessment of the Grisotti oncoplastic procedure for the management of central breast tumors

Breast J. 2021 Jul;27(7):595-602. doi: 10.1111/tbj.14256. Epub 2021 Jul 12.

Abstract

Introduction: The Grisotti technique consists to excise central breast tumor with nipple areolar and mobilize a dermo-glandular flap which is de-epithelized in order to reshape the breast and recreate an areola. The objective was to assess oncological results, postoperative side-effects, and patient and surgeon satisfaction rates resulting from this technique.

Materials and methods: From September 2016 to December 2019, 38 patients have been treated with a central breast tumor using the Grisotti technique.

Results: The mean age was 61.6 ± 11. The median body mass index was 27 kg/m² [20-42]. Thirty one patients benefited from a sentinel lymph node dissection. Preoperative histology found a majority of invasive ductal carcinomas (IDC) (71%). There were no intraoperative complications, and the average operating time was 90 min [60-200]. Postoperative histology found IDC associated with ductal carcinoma in situ in 28 patients. The surgical margins were invaded in two patients (reoperated by mastectomy after adjuvant treatment) and invasion of a margin of less than 1 mm in another six patients (supplemented by re-excision). The main postoperative complications were an abscess of the operating site and a partial necrosis of the neo-areola. The appearance of the breasts after radiotherapy gives a high satisfaction rate, both for patients and for surgeons.

Conclusion: The Grisotti technique is an easily reproducible procedure without major complications. It makes it possible to perform a carcinological satisfactory central lumpectomy, correction of the central glandular defect, and reconstruction of a new areola.

Keywords: Grisotti technique; breast-conserving treatment; central breast tumors; oncoplastic surgery; satisfaction rate.

MeSH terms

  • Aged
  • Breast Neoplasms* / surgery
  • Female
  • Humans
  • Mammaplasty* / adverse effects
  • Mastectomy
  • Mastectomy, Segmental
  • Middle Aged
  • Nipples / surgery
  • Retrospective Studies