Is It Safe for An Asian Woman To Be Pregnant after TRAM Flap Surgery for Breast Reconstruction?-A Case Report

Abstract

Background: Breast cancer is a thriving disease in Taiwan society and the population is more and more younger. Transverse rectus abdominis muscle flap (TRAM flap) reconstruction is the most common used autologous tissue after mastectomy. However, due to the increasing women who are diagnosed of breast cancer before pregnancy, it is a rising question about that the increasing intra-abdominal pressure could or could not compromise the healing scar. Aim and objective: We report a 28-year-old female who became pregnant 7 years after TRAM flap breast reconstruction surgery. This is the few case of Asian women of this kind. The literatures on cases pregnant after breast reconstructions of TRAM and DIEP breast reconstruction are reviewed. Materials and methods: This 28-year-old female was diagnosed of breast cancer and received right skin-sparing mastectomy and immediate breast reconstruction with left unilateral pedicled TRAM flap. During the procedure, only the central one third part of the rectus muscle was dissected and prepared as the vascular pedicle; the donor defect after dissection of the pedicle was closed securely by two layers sutures with 2-0 Nylon of the preserved lateral and medial strips of fascia and muscle. There was no use of mesh for the closure of the defect. Results: The post-operation course and gestation course of this case were unremarkable and no complications noted. She had a beautiful baby girl. Conclusions:Women who had TRAM flap breast reconstruction are capable of bearing a child during pregnancy and delivered smoothly.