Immediate breast reconstruction with extended lalissimns dorsi flap after mastectomy in 162 cases of breast cancer

Abstract

Objective To evaluate immediate breast reconstruction with extended latissimus dorsi flap after mastectomy for patients of breast cancer. Methods One hundred and sixty-two women with breast cancer underwent surgery from Jan, 2000 to Dec, 2007. Mastectomy was carried out including traditional modified mastectomy in 32 cases, skin sparing mastectomy in 51 cases and nipple-areolar sparing mastectomy in 79 cases. Immediate breast reconstruction was performed with latissimus dorsi flap and surrounding fat tissue. Results Operation was successful in 161 cases. The morphology of reconstructed breasts was excellent in 91.93% cases as evaluated by patients themselves. After operation 6 cases had partial nipple necrosis, 5 cases had rhacoma of the chest, but cured conservatively. Eleven cases had seroma on the back, among them 8 cases cured by puncture and drainage. Two cases cured by erasion of the pseudomembrane and 1 case cured by exairesis of the fibrous capsule. Three cases had limited skin necrosis around the incision. One case had necrosis on part of the donor side, cured by reoperation. One case had implant necrosis necessitating removal of the implant. The patients were followed up for 7 ~ 90 months, and the 23 cases were free of tumor recurrence before they lost to follow-up. Among those followed-up cases there were bone metastasis in 2 cases, lung metastasis in 1 case and supra clavicular lymph node metastasis in one. No local recurrence was found. Conclusions Immediate breast reconstruction with extended latissimus dorsi flap after mastectomy is safe and effective, especially suitable for small and medium size breasts. Key words: Breast neopalsms ; Mammaplasty ; Surgical flaps