Abstract
Background: The latissimus dorsi (LD) muscle flap plays an essential role in breast reconstruction after partial mastectomy for cancer because of its stability and versatility. We evaluated both oncologic and aesthetic outcomes in addition to the related complications of this flap as an adjunct to breast conserving surgery in the management of breast cancer patients. Methods: All patients underwent a one-stage procedure with immediate reconstruction through two-steps operation; wider local excision utilizing oncoplastic principles and mini flap harvest & volume replacement. Results: The study included 34 cases with early breast cancer; 30 patients had partial breast resection and defect refilling by LD mini-flap, three patients underwent mastectomy and one patient underwent extended LDF. The mean defect volume was (212.63 cm3 ± 59.57) cm3, while the mean flap volume was (218.27 cm3 ± 53.64 cm3). Patient self-evaluation of the cosmetic outcome was excellent in 20%, good in 60% and satisfactory in 20% of patients. Panel evaluation according to Harvard scale showed excellent in 36.7%, good in 36.7%, fair in 26.7% of patients. The median hospital stay was 4 days. The postoperative complications included wound gap in 4 patients (13.3%), postoperative donor site seroma in 16 patients (53.3%). No flap loss or necrosis, no affection on arm or shoulder mobility occurred. Lastly, no tumor recurrence till now. Conclusion: Latissimus dorsi mini-flap can achieve adequate cosmetic and oncologic outcomes with a low incidence of complications in patients with early stage (I/II) breast cancer and small to medium sized breasts.
Highlights
Breast conservation is oncologically safe and can be properly achieved in about 70% of patients with early stage (I-II) breast cancer [1] [2] with an equal 5-year survival to mastectomy [3]
The latissimus dorsi (LD) muscle flap plays an essential role in breast reconstruction after partial mastectomy for cancer because of its stability and versatility
We evaluated both oncologic and aesthetic outcomes in addition to the related complications of this flap as an adjunct to breast conserving surgery in the management of breast cancer patients
Summary
Breast conservation is oncologically safe and can be properly achieved in about 70% of patients with early stage (I-II) breast cancer [1] [2] with an equal 5-year survival to mastectomy [3]. In 2002, Rainsbury described LD mini flaps aiming to reconstruct the partial breast defects after central and upper quadrant resections This oncoplastic approach allows extensive local excision during BCS without cosmetic penalties in a group of patients to avoid mastectomy [10]. The latissimus dorsi (LD) muscle flap plays an essential role in breast reconstruction after partial mastectomy for cancer because of its stability and versatility We evaluated both oncologic and aesthetic outcomes in addition to the related complications of this flap as an adjunct to breast conserving surgery in the management of breast cancer patients. Conclusion: Latissimus dorsi mini-flap can achieve adequate cosmetic and oncologic outcomes with a low incidence of complications in patients with early stage (I/II) breast cancer and small to medium sized breasts
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