• The patient was a 55 year old female who presented with lobular carcinoma, grade 2, ER positive, PR positive, HER2 negative.
• The lesion was located in the upper quadrant of her right breast, 5cm from the nipple, at the 12 o’clock position, measuring 5mm.
• Oncoplastic excision of the lesion with crescent mastopexy was planned along with a sentinel lymph node biopsy.
• To localise the tumour, a magnetic seed was placed in the lesion preoperatively. A handheld localization probe was used to create the lumpectomy specimen by locating the preoperatively placed magnetic seed.
• Intraoperative radiography was performed on the lumpectomy specimen to ensure good margins and the removal of the localization marker.
• Surgical clips were placed throughout the lumpectomy cavity to assist with postoperative radiation planning.
• The epidermis was removed along the crescent pattern in a process called de-epithelialization. This allowed for the inset of the crescent under the skin flap.
• Dual plane undermining was used, to approximate the parenchyma, in the area of resection, to prevent post operative denting.
• And the incision was closed using interrupted deep dermal sutures and reinforced using running subcuticular sutures.
• Due to the nature of the areolar border a visible scar is visibly hidden by the colour and texture of the areola.
• The treatment was followed up with postoperative radiation, guided by the intraoperatively placed surgical clips.

The Breast Surgical Oncology chapter is supported by Judy Winberg and Andy Pollack through the Winberg Foundation.