Reliability and oncological safety of pedicled skin island therapeutic mammoplasty as an alternative to Grisotti mastopexy for centrally located breast cancer patients.

Nagm Eldin Abu Elnga, Mohamed K Safina, Mahmoud Refaat Shehata, Mahmoud T Ayoub, Ahmed Soliman

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Article in World journal of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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Nagm Eldin Abu ElngaGeneral Surgery Department, Faculty of medicine, Assiut University, Assiut, Egypt. nagmdairy@med.au.edu.eg.

Mohamed K SafinaGeneral and oncology surgery Department, Faculty of medicine, New Valley University, Assiut, 71526, Egypt.

Mahmoud Refaat ShehataGeneral Surgery Department, Faculty of medicine, Assiut University, Assiut, Egypt.

Mahmoud T AyoubGeneral Surgery Department, Faculty of medicine, Assiut University, Assiut, Egypt.

Ahmed SolimanGeneral Surgery Department, Faculty of medicine, Assiut University, Assiut, Egypt.

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6 · The paper itself

Abstract

backgroundCentrally located breast cancers (CLBC) involving the nipple-areolar complex (NAC) pose a significant challenge for breast-conserving surgery, often necessitating mastectomy. The Grisotti flap, while a valuable oncoplastic technique, has limitations in vascular reliability and applicability, especially post-neoadjuvant chemotherapy. We introduce a novel "Pedicled Skin Island Therapeutic Mammoplasty" (PSI-TM) as an alternative.

methodsThis single-center retrospective study analyzed 23 consecutive patients with CLBC infiltrating or fixed to the NAC who underwent PSI-TM between April 2018 and June 2023. All patients had medium-to-large breast volumes (Cup C/D). Data on demographics, tumor characteristics, surgical outcomes, complications, aesthetic results, and oncological safety were collected and analyzed.

resultsThe cohort was predominantly premenopausal (82.6%) with invasive ductal carcinoma (87.0%). Most patients (73.9%) were treated post-neoadjuvant chemotherapy. The overall complication rate was 21.7% (5/23), all Clavien-Dindo Grade I-II, with no returns to the operating room. The combined ratings from the surgeon and independent observer were 'Good' or 'Very Good' in 73.9% of cases (17/23). Over a median follow-up of 50 months, there were no instances of positive margins, local recurrence, or distant metastasis.

conclusionPSI-TM is a feasible and safe oncoplastic technique for CLBC with NAC involvement. It may offer improved vascular security compared to the traditional Grisotti flap based on theoretical anatomical advantages, leading to low complication rates, excellent aesthetic results, and encouraging early oncological outcomes, even in a post-neoadjuvant setting.

Indexed as

Breast NeoplasmsCarcinoma, Ductal, BreastMammaplastyMastectomy, SegmentalPostoperative ComplicationsSurgical FlapsAdultAgedFemaleFollow-Up StudiesHumansMiddle AgedNeoadjuvant TherapyNipplesPrognosisReproducibility of ResultsBreast conservationCentrally located breast cancerGrisotti flapNipple-areolar complexOncoplastic breast surgeryPedicled skin island therapeutic mammoplasty

Identifiers

PMID42135779

DOI10.1186/s12957-026-04399-z

PMCPMC13181990

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