Evaluation of Anterior Intercostal Artery Perforator Flap for Oncoplastic Immediate Reconstruction Following Breast-Conserving Surgery in Lower Breast Quadrants Lesions; an Institutional-Based Study

Abstract

Introduction:The incorporation of oncoplastic surgery techniques in the management of breast cancer became more popular and offers both oncological safety and good cosmetic results. It is highly challenging for surgeons to obtain good oncological control and acceptable cosmetic results, especially in tumors in the lower quadrant of the breast. The utility of anterior Intercostal Artery perforator flap (AICAP) in immediate reconstruction following breast-conserving surgery (BCS) is rarely described in the literature. In our study, we present our experience with the Anterior Intercostal Artery Perforator flap in 20 patients with small to medium-sized breasts.Patients and methods: From June 2018 to June 2021, twenty female patients underwent quadrantectomy followed by reconstruction using an AICAP flap. Results:The surgical excision margins were negative in all patients and no re-excision was needed. The dimensions of the flap were matching the defect size or were slightly larger due to anticipation of tissue shrinkage post radiation, with a mean of 7 × 5 × 3 cm (range of 4.6-10 × 3-6× 2-5 cm). The postoperative complications were observed in only one patient (5%) in the form of mild wound infection. An average percentage of excellent to good results was obtained in 95% of cases. Conclusion:The AICAP flap is an important addition in the field of oncoplastic immediate reconstruction after BCS, especially in patients with small to moderate breast sizes. The technique is oncologically safe and provides improved aesthetic results after quadrantectomy for tumors in the lower quadrants of the breast.