Study of options and procedures in reconstruction of post mastectomy breast defects in a regional cancer centre

Abstract

Background: Post mastectomy autologous breast reconstruction is challenging and involves restoring the patients lost structure and prepping the patient for adjuvant therapy and also psychosocial benefits that comes with early breast reconstruction. We analysed latissimus dorsi flap, transverse rectus abdomenis flap, deep inferior epigastric perforator flap and thoracoabdominal flap. Aim was to reconstruct post mastectomy defect using various methods, to enable the patient to receive early adjuvant therapy. Objectives were to study the various procedures used for post mastectomy defect autologous breast reconstruction. To evaluate the reliability of various flaps used. To evaluate the complications of flaps and their management. To assess the advantages and disadvantages of each flap. Methods: 42 post mastectomy defect patients reconstructed with 4 flaps over 24 months, included in the study and results analysed. Results: In 42 cases, latissimus dorsi flap was done in 11 cases, transverse rectus abdominis flap was done in 6 cases, deep inferior epigastric perforator flap was done in 3 cases and thoracoabdominal flap was done in 22 cases. Total flap loss in 1 case and partial flap loss in 6 cases was seen. Conclusions: Immediate autologous breast reconstruction is helpful in making the patient ready for upcoming adjuvant therapy along with psychosocial benefits. We have analysed 4 different types of flaps and compared their advantages and disadvantages. We found that thoracoabdominal flap is a good option of immediate coverage in low socioeconomic class patients and ones with terminal disease.