Due to the location of the tumour in the upper central quadrant, an inferior-based pedicle reduction mammoplasty was performed. The skin over the tumour was resected, and the NAC was reconstructed in this position. Reoperation sentinel node biopsy found one negative node; no axillary dissection was done. A contralateral reduction (inferior-based pedicle) for symmetrisation was performed concomitantly.

The postoperative course was uneventful. Final histology found a 15 mm tumour with wide free margins. Radiation therapy was applied for 6 weeks with a boost to the tumour.

The cosmetic result 4 years after surgery was rated as an inferior cosmetic outcome by the surgeon, but not by the patient (Fig. 30.2a, b). This was due to the position of the NAC, which was located too high in the upper quadrant and with a NAC to inframammary fold distance of 9 cm. Not taking into account the position of the NAC, the volume and the size of the breast were rated as a good result. The patient declined to undergo symmetrisation mastopexy on the left breast.