Skin-sparing mastectomy with immediate latissimus dorsi flap reconstruction versus delayed reconstruction after modified radical mastectomy

Abstract

Background: Oncoplastic breast surgery is a safe option in the treatment of early-stage breast cancer that preserves cosmoses without compromising recurrence or survival. Skin sparing mastectomy is oncologically safe based on the absence of breast ductal epithelium at the margin of the native skin flaps. Breast reconstruction with latissimus dorsi (LD) flap produces a high rate of good aesthetic results.Methods: This clinical study included 20 patients who were managed in the general surgery department, Menofiua university hospitals from April 2017 to March 2019. All patients had early breast cancer.Results: Patients with SSM were younger than those with LD flap. In cases of SSM LD flap, average of operative time was 4.95 hours, range 4-6.5 hours, and a median of 4.75 hours with SD ±0.89. While in cases who did delayed LD flap Average time 2.8 hours and range 1.5-3.5 hours and SD ±0.65. The difference was significant. Average blood loss for the patients underwent SSM with LD flap was 975 cc while in those who underwent delayed LD flap reconstruction was 520 cc, and the difference was significant.Conclusions: Skin-sparing mastectomy with immediate LD has become popular; it improves the cosmetic result, reduces cost, and anesthetic risk. It doesn't interfere with radiotherapy or chemotherapy.