Due to the aggressive type of the cancer, a wide quadrantectomy using a modified reduction mammoplasty with the basis of the T being in the inner quadrant was planned (Fig. 37.1b, c). Following quadrantectomy (resection weight: 420 g), the gland was dissected off the major pectoral muscle to allow adequate mobilization and closure of the defect without tension. The skin around the areola was de-epithelialized and the areola was recentralized (areolapexy) into the new center of the breast (Fig. 37.2a–c). Sentinel node biopsy was done through a separate incision in the axilla and revealed 2 negative nodes.