Oncoplastic volume replacement techniques according to the excised volume and tumor location in small- to moderate-sized breasts.

Abstract

In the treatment of cancer patients with small breasts, breast-conserving surgery (BCS) with adjuvant radiotherapy has become popular. In Korean women, many of whom have small- to moderate-sized breasts, the removal of an adequate volume of tissue during breast cancer surgery may compromise the cosmetic outcome and sometimes cause unpleasant results. In such cases, oncoplastic volume replacement techniques can be valuable. Between January 2007 and December 2013, 213 women underwent 216 BCSs with various oncoplastic volume replacement techniques selected according to the volume of breast tissue excised. When the excised volume was <150 g, regional flaps such as a lateral thoracodorsal or thoracoepigastric flap, or perforator flaps such as an intercostal artery perforator (ICAP) flap or a thoracodorsal artery perforator (TDAP) flap were used. When the excised volume was >150 g, a latissimus dorsi (LD) myocutaneous flap was used. The mean age was 45.7 years, and the mean follow-up interval was 11.3 months. The mean excised volume was 148.4 g. The oncoplastic volume replacement techniques used included 22 lateral thoracodorsal flaps, 8 thoracoepigastric flaps, 29 ICAP flaps, 20 TDAP flaps, and 137 LD myocutaneous flaps. Postsurgical complications occurred in 30 cases, including 1 case of congestion and 26 cases of seroma in LD myocutaneous flaps, and 3 cases of fat necrosis in ICAP flaps. Most of the patients were satisfied with the cosmetic outcome. Oncoplastic volume replacement techniques according to the excised volume and tumor location are reliable and useful for the correction of breast deformity after BCS, especially in patients with small- to moderate-sized breasts.