Evaluation of donut mastopexy as a conservative breast surgery in juxta areolar early breast cancer
Authors: Abdallah Mahmoud A. H. , Mostafa Ashraf A. , Osman Ahmed G. , Ayoub Bishoy R. 
Published: August 2023

Background
In order to give a treatment as effective as mastectomy with the added benefit of a preserved breast, breast conserving surgery has evolved into the accepted course of action for the diagnosis and treatment of breast cancer. Donut mastopexy is one of the cancer breast surgery techniques that is used.

Objective
Evaluation of donut mastopexy as a conservative breast surgery in juxta areolar breast cancer.

Methods
A total of 50 female patients with early breast cancer near nipple-areolar complex were enrolled. Cosmetic outcome was evaluated during the early postoperative period and on follow-up. Operative time, intra and postoperative bleeding, drain content, wound complication as seroma or surgical site infection, symmetry, patient and doctor satisfaction were evaluated.

Results
Breast imaging reporting and data system (BI-RADS) classification of the obtained specimens of the study population showed that 12 (24%) had grade 4 and 38 (76%) had grade 5. Preoperative tru-cut biopsies of the obtained specimens of the study showed that 34 women (68%) had infiltrative ductal carcinoma, 10 women (20%) had ductal carcinoma in situ, four women (8%) had infiltrative lobular carcinoma and two women (4%) had mucinous carcinoma. Preoperative true-cut biopsies of the obtained specimens showed that 34 patients (68%) had infiltrative ductal carcinoma, 10 patients (20%) had ductal carcinoma in situ, four patients (8%) had infiltrative lobular carcinoma and two patients (4%) had mucinous carcinoma in-situ component of the obtained specimens showed that 13 patients (26%) had no in-situ component, 16 patients (32%) had less than or equal to 5% and 21 patients (42%) had greater than 5-25% intraoperative bleeding were three patients (6%); mean of drain content (volume) was 26.29±2.79 and mean of operative time (min) was 93.16±13.62. The most common complication was seroma (10%) and four patients (8%) were bleeding; followed by hematoma and delayed wound healing, and there was agreement on the ratio (6%) and infection and axillary wound seroma, and there was agreement on the ratio (4%), on the other hand partial nipple/skin necrosis and wound dehiscence was the lowest noticed complication, and there was agreement on the ratio (2%); as for the surgical site infection was five patients (10%) were hotness, four patients (8%) were redness and three patients (6%) were swelling. The patient satisfaction was 33 patients (66%) were excellent of satisfaction, nine patients (18%) were very good of satisfaction, seven patients (14%) were good satisfaction, and one case (2%) was poor satisfaction. Additionally, there was 31 doctors (62%) were excellent of satisfaction, 11 doctors (22%) were very good of satisfaction, 8 doctors (16%) were good satisfaction, while there is no poor cases among doctor satisfaction.

Conclusion
Donut mammography results in good cosmetic results. The study’s overall cosmetic outcome was more gratifying, and this was evident in the patients’ psychological health and sense of self-worth.