Abstract
BackgroundBreast conserving surgery (BCS) has been a standard procedure for the treatment of breast cancer instead of mastectomy whenever possible. Lateral chest wall perforator flaps are one of the volume replacement techniques that participate in increasing the rate of BCS especially in small- to moderate-sized breasts with good cosmetic outcome. In this study, we tried to evaluate the outcome of those flaps as an oncoplastic procedure instead of the conventional flaps.MethodsThis study included 26 patients who underwent partial mastectomy with immediate reconstruction using lateral chest wall perforator flaps in the period from October 2019 to November 2020. The operative time, techniques, and complications were recorded. The cosmetic outcome was assessed 3 months post-radiation therapy through a questionnaire and photographic assessment.ResultsLateral intercostal artery perforator (LICAP), lateral thoracic artery perforator (LTAP) and combined flaps were performed in 24, 1, and 1 patients, respectively. The mean operative time was 129.6 ± 13.2 min. The flap length ranged from 10 to 20 cm and its width from 5 to 9 cm. Overall patients’ satisfaction was observed to be 88.5% as either excellent or good and the photographic assessment was 96.2% as either excellent or good.ConclusionsLateral chest wall perforator flaps are reliable and safe option for partial breast reconstruction with an acceptable aesthetic outcome. In the era of oncoplastic breast surgery, they deserve to gain attention especially with the advantages of some modifications added to the classic technique.
Highlights
Breast conserving surgery (BCS) has been a standard procedure for the treatment of breast cancer instead of mastectomy whenever possible
Lateral intercostal artery perforator (LICAP) flap technique and the anatomy of lateral intercostal artery perforators were well described by Hamdi et al [4]
Meybodi et al added few modifications to overcome the limitations of the classic LICAP flap, avoiding the need to reposition the patient from the supine to the lateral position to harvest the flap
Summary
Breast conserving surgery (BCS) has been a standard procedure for the treatment of breast cancer instead of mastectomy whenever possible. Perforator flaps are one of the volume replacement oncoplastic techniques that can be used after BCS to reconstruct challenging defects in a relatively large tumor to breast ratio [1]. Meybodi et al added few modifications to overcome the limitations of the classic LICAP flap, avoiding the need to reposition the patient from the supine to the lateral position to harvest the flap. They shifted the flap design to a more vertical ellipse resulting in a more hidden and better scar [5]. The aim of this study is to evaluate the reliability and safety of those flaps in partial breast reconstruction
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