Burow’s Triangle Rotational Advancement Flap with Accelerated Partial Breast Irradiation for Upper Inner Quadrant Early Breast Cancer

Oncoplastic techniques in breast cancer treatment allow increasing indications of breast-conserving surgery and improving cosmetic results. Breast tumours located at the upper inner quadrant present a challenge for conservative surgery due to insufficient breast thickness and risk of skin involvement. We present a case of 65 year postmenopausal lady with hormone receptor positive early breast cancer in upper inner quadrant of left breast (cT2N0M0) who underwent breast-conserving surgery with matrix rotation mammaplasty, using a modified Burow’s triangle advancement flap and interstitial brachytherapy catheter placement. She received APBI (34 Gy in 10 fractions over 5 days) and was discharged on the 7th post-operative day after completion of treatment in single admission without any complications. The patient was not desirous of either symmetrization or displacement of the nipple-areola complex. During follow-up at 3 months, the patient was satisfied with the cosmesis and preservation of the breast, and no local recurrence was detected. She was then placed on adjuvant hormonal therapy. We conclude that the modified Burow’s triangle advancement flap is a safe and reasonably easy technique to manage tumours at this complex location .