Breast cancers in patients with large breasts can often be successfully treated with lumpectomy. In larger breasted women, after the tumor is removed, there is still a significant amount of breast tissue available to reconstruct the breast. The standard mastopexy or lift patterns of the breast can be used to remove the tumor. On occasion, the tumor that needs to be removed lies outside of the normal mastopexy pattern. If the tumor is superficial and lies in close proximity to the skin then it is beneficial to remove the skin above the tumor. This is done to reduce the chances of a positive anterior margin which is the skin overlying the tumor. The resulting scar pattern is changed from that which is a standard inverted T-incision to one which is in the shape of a “Z” or backwards “Z”. These patients are often very happy with the overall shape and appearance of the breast.