An Innovative Approach for Breast Conservation in a Patient With Multicentric Upper Inner and Central Quadrant Breast Tumors

Oncoplastic breast surgery expands the number of options for conservative breast cancer treatment. Traditionally, patients with multicentric tumors, especially those in the upper and central quadrant, were offered mastectomy. Recent evidence supports the safety and feasibility of breast conservation surgery even in patients with multifocal and multicentric breast cancer. However, there remains a challenge to achieve wide local excision of tumors while maintaining a good cosmetic outcome, especially in central and upper inner quadrant tumors. Here, we present a case where a patient with multicentric upper inner and central quadrant tumors was managed with breast-conserving surgery: wire bracketing of the lesions with wide local excision with nipple-areolar complex, followed by volume replacement and areolar reconstruction with medial intercostal artery perforator (MICAP) flap. The patient had a satisfactory cosmetic outcome with no complications. She continues to be disease-free and satisfied with the postoperative result at 15 months post operation.