Impact of skin-sparing mastectomy with immediate reconstruction and breast-sparing reconstruction with miniflaps on the outcomes of oncoplastic breast surgery

Gendy, R.; Able, J. A.; Rainsbury, Richard

doi:10.1002/bjs.4060

Cited by 82 publications

(54 citation statements)

References 25 publications

(27 reference statements)

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“…These statistics clearly demonstrated the advantage of partial mastectomy and immediate reconstruction in properly selected women. 21 Pezner et al concluded in their report in 1985 that the goal of breast-preserving treatment for patients with stage I or II breast carcinoma is to provide a cancer control rate at least equal to that of standard breast cancer treatment, and at the same time to provide good cosmetic results, because if a good cosmetic result cannot be achieved, then a patient might be better off having a total mastectomy with the option of breast reconstruction. 5 Larger defects in patients who undergo immediate reconstruction usually correlate with a lower incidence of positive postoperative tumor margins; 22 however, wide local excision without immediate volume replacement is associated with breast retraction, leading to cosmetic failure in one-third of patients.…”

Section: Discussionmentioning

confidence: 96%

Immediate breast reconstruction using autologous free dermal fat grafts provides better cosmetic results for patients with upper inner cancerous lesions

et al. 2011

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Section: Discussionmentioning

confidence: 96%

Immediate breast reconstruction using autologous free dermal fat grafts provides better cosmetic results for patients with upper inner cancerous lesions

et al. 2011

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“…This favorable cosmetic result therefore, justifies the use of LDF reconstruction in our practice for breast cancer surgery. The main advantage of such method is the creation of natural breast ptosis, this also mentioned by other studies [19][20][21].…”

Section: Discussionmentioning

confidence: 73%

Different Modalities of Breast Reconstruction with Autologous Latissimus Dorsi Flap: Aesthetic Results and Complications

Fakhry¹

2015

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Abstract:Background. Use of an autologous latissimus dorsi (LD) flap in breast reconstruction accounts for a flexible and natural look of reconstructed breast and has maintained a strong popularity because of its ease of harvest, reliability, and ability to provide additional prosthetic coverage. Different complications (hematoma, seroma, flap necrosis, infection, hypertrophic scarring, and postoperative back pain) linked to this type of breast reconstruction. The aim of this study was to evaluate the complications and aesthetic outcome of (LD) flap breast reconstruction after breast cancer surgery. Materials and methods. forty patients underwent breast reconstruction using (LD) flap with a follow-up period ranged from 6 to 18 months. Patients with small to medium sized breasts underwent complete reconstruction by extended (LD) flap after mastectomy either subcutaneous or skin sparing mastectomy while patients with large pendulous breast underwent Augmentation by (LD) miniflap after conservative surgery by wide local excision (WLE) with safety margin. All patients gave their informed consent for the procedure and were aware of the potential complications and the possibility of secondary procedures. Results. The ages of the patients in our study ranged from 25 to 65 years old. 28 (70%) patients underwent (WLE) and reconstruction with (LD) miniflap while modified radical mastectomy, skin sparing mastectomy and subcutaneous mastectomy were done in 2(5%), 4(10%) and 6(15%) patients respectively with complete reconstruction by extended(LD) flap. The complication rates were noted as follows: partial flap necrosis in 4 patients (10%), wound breakdown in 2 patients (5%), lymphorrhea in 2 patients (5%), seroma in 6 patients (15%). Some of patients showed a minor deformity in the back, which disappeared with time and most patients, had temporary limitation of shoulder movements postoperatively but all recovered completely within few weeks. No patients underwent secondary nipple and areola reconstruction. No local recurrence or distant metastasis in any patient during the follow up period of our study. Evaluation of aesthetic results by patients revealed that 30 patients (75%) were deeply satisfied, 6 patients (15%) were satisfied and 4 patients (10%) were poorly satisfied. While, surgeon aesthetic evaluation was good in 28 patients (70%), satisfactory in 8 patients (20%) and fair in 4 patients (10%). Conclusion. (LD) flap breast reconstruction is a very versatile, safe and satisfactory technique with high success rate and is even suitable for high-risk patients. Donor site seroma is the most common complication and can be treated by repeated aspiration in outpatient clinic. Latissimus dorsi (LD) miniflap is the mainstay of breast reconstruction after partial mastectomy to repair defects in the lateral quadrants and the lower inner pole with low donor site morbidity and deep patient satisfaction.

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“…RT after prosthetic reconstruction is known to lead to an unsatisfactory result (11), which is why prostheses are usually used in late reconstructions. The newest technique including a segmental resection of the breast and reconstructing only part of the breast with a smaller musculocutaneous LD-flap (combined with postoperative RT) is called the LD-miniflap technique (12). Surgical complications remain fewer after LD-miniflap technique compared to extended LD technique, where much of the fat overlying the latissimus dorsi muscle is used to increase the size of the flap (13,14).…”

Section: Discussionmentioning

confidence: 99%

Recurrences after Immediate Reconstruction in Breast Cancer

et al. 2005

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Aim:To determine the incidence of and reasons for recurrences after immediate breast reconstruction in breast cancer patients.Material and Methods: The data of 79 patients undergoing immediate breast reconstruction between 1998 and 2001 in Kuopio University Hospital were re-examined from both the local cancer register and the patient charts at the end of year 2003.Results: There were five local recurrences (6.3 %), one regional recurrence (1.2 %), and three cases (3.8 %) presented bone and/or visceral metastases. All recurrences except one (primary tumor noninvasive) appeared within the first two years after primary therapy. Young age and increasing size of the tumour were risk factors for distant or logoregional metastases.Conclusion: Immediate breast reconstruction is a safe procedure in breast cancer patients, but a multidisciplinary team is needed for careful patient selection.

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Impact of skin-sparing mastectomy with immediate reconstruction and breast-sparing reconstruction with miniflaps on the outcomes of oncoplastic breast surgery

Abstract: LDMF was associated with fewer adverse surgical and physical sequelae than SSM, without compromising local control or cosmetic outcome. Both operations were associated with low psychological morbidity.

Cited by 82 publications

References 25 publications

Immediate breast reconstruction using autologous free dermal fat grafts provides better cosmetic results for patients with upper inner cancerous lesions

Immediate breast reconstruction using autologous free dermal fat grafts provides better cosmetic results for patients with upper inner cancerous lesions

Different Modalities of Breast Reconstruction with Autologous Latissimus Dorsi Flap: Aesthetic Results and Complications

Recurrences after Immediate Reconstruction in Breast Cancer

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