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A balance between breast reconstruction and amputation, Goldilock mastectomy
- Authors: Zhiltsova E.K.1, Krivorotko P.V.1, Ulrikh D.G.1,2, Bondarchuk Y.I.1, Kalishevich U.S.3, Levchenko V.E.1, Enaldieva D.A.1, Amirov N.S.1, Solomakhina A.V.1, Mortada V.V.1, Pesotskiy R.S.1, Zernov K.Y.1, Emelyanov A.S.1, Tabagua T.T.1, Gigolaeva L.P.1, Komyakhov A.V.1, Nikolaev K.S.1, Yereshchenko S.S.1, Semiglazov V.F.1
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Affiliations:
- N.N. Petrov Research Institute of Oncology, Ministry of Health of Russia
- I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia
- Saint-Petersburg State Pediatric Medical University
- Issue: Vol 21, No 1 (2025)
- Pages: 44-55
- Section: MAMMOLOGY. ORIGINAL REPORTS
- Published: 08.05.2025
- URL: https://ojrs.abvpress.ru/ojrs/article/view/1347
- DOI: https://doi.org/10.17650/1994-4098-2025-21-1-44-55
- ID: 1347
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Abstract
Background. Goldilocks mastectomy is an innovative surgical technique developed for patients with breast cancer who are looking for a balance between oncologically safe tumor removal and an optimal final aesthetic result.
Aim. To perform an optimal type of reconstruction in overweight patients with serious comorbidities who have abandoned the standard options for restoring the shape of the breast by preserving a de-epidermized lower flap during mastectomy.
Materials and methods. This study included 22 patients (31 Goldilocks mastectomy) aged 31 to 75 years diagnosed with breast cancer who received treatment from June 2023 to November 2024 at the N.N. Petrov Research Institute of Oncology. The average body mass index was 29.69 ± 3.92 kg/m2. Obesity was diagnosed in 86.4 % (19/22) of cases. All patients had 2 or 3 degrees of mammary gland ptosis.
Results. In 59.1 % (13/22) of cases patients underwent unilateral Goldilocks mastectomies, in 40.9 % (9/22) – bilateral operations using this technique. In 16 patients (72.7 %) the nipple-areolar complex was preserved. The overall complication rate was 12.9 % (4/31). The patients noted that the final subjective perception of the treatment results exceeded the expectations of the performed surgical intervention.
Conclusion. Breast reconstruction in overweight patients can be performed in various ways. Based on the experience of the N.N. Petrov Research Institute of Oncology and the results of this study, Goldilocks mastectomy is the best reconstruction option for patients with high body mass index or ptosis of the mammary glands, as well as concomitant diseases. This technique allows the surgeon to remove breast tissue within the anterior and posterior leaves of the superficial fascia, create additional volume using a de-epidermized flap, which preserves oncological safety and improves the aesthetic result.
About the authors
E. K. Zhiltsova
N.N. Petrov Research Institute of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0002-2029-4582
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationP. V. Krivorotko
N.N. Petrov Research Institute of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0002-4898-9159
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationD. G. Ulrikh
N.N. Petrov Research Institute of Oncology, Ministry of Health of Russia; I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia
Author for correspondence.
ORCID iD: 0000-0002-1346-933X
Darya Glebovna Ulrikh
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
47 Piskarevskiy Prospekt, Saint Petersburg 195067
Russian FederationYa. I. Bondarchuk
N.N. Petrov Research Institute of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0002-6442-0106
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationU. S. Kalishevich
Saint-Petersburg State Pediatric Medical University
ORCID iD: 0009-0003-0409-1966
2 Litovskaya St., Saint Petersburg 194100
Russian FederationV. E. Levchenko
N.N. Petrov Research Institute of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0002-2773-3111
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationD. A. Enaldieva
N.N. Petrov Research Institute of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0002-2421-3284
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationN. S. Amirov
N.N. Petrov Research Institute of Oncology, Ministry of Health of Russia
ORCID iD: 0009-0003-6597-376X
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationA. V. Solomakhina
N.N. Petrov Research Institute of Oncology, Ministry of Health of Russia
ORCID iD: 0009-0007-6351-7938
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationV. V. Mortada
N.N. Petrov Research Institute of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0002-1982-5710
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationR. S. Pesotskiy
N.N. Petrov Research Institute of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0002-2573-2211
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationK. Yu. Zernov
N.N. Petrov Research Institute of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0002-2138-3982
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationA. S. Emelyanov
N.N. Petrov Research Institute of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0002-0528-9937
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationT. T. Tabagua
N.N. Petrov Research Institute of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0003-1471-9473
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationL. P. Gigolaeva
N.N. Petrov Research Institute of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0001-7654-4336
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationA. V. Komyakhov
N.N. Petrov Research Institute of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0002-6598-1669
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationK. S. Nikolaev
N.N. Petrov Research Institute of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0003-3377-6369
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationS. S. Yereshchenko
N.N. Petrov Research Institute of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0002-5090-7001
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationV. F. Semiglazov
N.N. Petrov Research Institute of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0003-0077-9619
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationReferences
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