Metastasis of Breast Cancer in the Donor Site After Breast Reconstruction With a Latissimus Dorsi Flap

Manassa, Edouard H.; Olbrisch, R. R.

doi:10.1097/01.prs.0000153822.17603.f1

Cited by 2 publications

(1 citation statement)

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“…Although this has not been reported previously in SAI flap donor sites, this complication has been reported in PMC flaps used for head and neck reconstruction 44 as well as in other cancers such as colorectal and breast. 45,46 Methods of tumor spread to the donor site are unclear, but could include lymphatic or hematogenous spread, direct seeding, or development of tumor due to surgical stress. Consideration should be given to changing gowns, gloves, and instruments, as well as copiously irrigating the wound after tumor ablation.…”

Section: Complicationsmentioning

confidence: 99%

Supraclavicular Artery Island Flap: Critical Appraisal and Comparison to Alternate Reconstruction

et al. 2020

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Objectives/Hypothesis: The supraclavicular artery island (SAI) flap may be a good option for selected head and neck reconstruction due to its reliability, ease of harvest, and favorable color match. The objective of this study was to examine the rates of complications for the SAI flap in head and neck oncologic reconstruction, with examination of risk factors and comparisons to alternative flaps often considered the gold-standard soft-tissue flaps for head and neck reconstruction: the pectoralis myocutaneous (PMC), radial forearm free flap (RFFF), and anterolateral thigh (ALT) flaps.Study Design: Retrospective cohort study. Methods: Consecutive SAI flaps were compared to PMC, RFFF, and ALT flaps (non-SAI flap group), all performed by the senior author from 2010 to 2018. The non-SAI flaps were included if an SAI flap could have been performed as an alternate flap. The groups were compared based on demographics, flap dimensions, site of reconstruction, operating time, total hospital stay, total hospital costs, and complications.Results: One hundred seven SAI flaps and 194 non-SAI flaps were identified. SAI flaps were used less commonly than non-SAI flaps for mucosal defects (P < .001). The SAI flap dimensions were narrower but longer than non-SAI flaps (P < .001). SAI flaps had higher rates of total complications, partial flap necrosis, flap dehiscence at the recipient site, fistula, donor site dehiscence, and minor complications compared to non-SAI flaps (all P < .05). SAI flaps had higher rates of total complications, recipient site dehiscence, fistula, and minor complications in both the oral cavity and all mucosal sites compared to non-SAI flaps (all P < .05). SAI flaps for mucosal reconstruction were associated with higher rates of total complications (54% vs. 34%, P = .04), flap dehiscence at the recipient site (32% vs. 14%, P = .03), and major complications (21% vs. 5%, P = .02), compared to cutaneous reconstruction. Complications were equivalent between SAI flaps and non-SAI flaps for cutaneous reconstruction (all P > .05). Multivariate analysis showed that SAI flaps were associated with any postoperative complication (odds ratio [OR]:

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Section: Complicationsmentioning

confidence: 99%

Supraclavicular Artery Island Flap: Critical Appraisal and Comparison to Alternate Reconstruction

et al. 2020

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Lymphatic drainage study after latissimus dorsi flap breast reconstruction

et al. 2014

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Background Recurrence of breast cancer to latissimus dorsi (LD) flap donor site is a very rare condition, and as a result, few data are currently available on its possible causes. The aim of the study was to investigate the role of LD flap transfer in lymphangiogenesis and connection to the preexisting lymphatic network after mastectomy and axillary lymph node dissection and the lymphatic drainage involvement in local relapse to flap donor site. Methods Lymphoscintigraphy was performed on subgroup of ten patients who had previously undergone modified radical mastectomy, axillary lymph node dissection, and pedicled LD flap reconstruction. Lymphatic drainage was imaged by static gamma camera acquisitions after two intradermal injections of 37 MBq 99mTc-Nanocoll® on residual breast skin and LD skin paddle, respectively. Results In eight cases (80 %), the residual breast skin showed fast lymphatic drainage directed only toward the ipsilateral axilla, while in two cases (20 %), it was also seen to the internal mammary nodes. LD skin paddle showed slower drainage in all cases but 1, where no visible drainage was observed within 2 h after injection. Conclusions Although a small case series is the study limitation, our findings suggested that the LD flap harvest can promote a preferential route of lymphatic drainage in the axillary region and could be involved in a metastatic spread to the dorsum because of the new tissue plane opening. The direct communication created between recipient and donor sites could have lead to cell cancer transfer to the donor site either by lymphatic or a contiguity pathway.Level of Evidence: Level V, diagnostic study. © 2014 Springer-Verlag Berlin Heidelberg

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Metastasis of Breast Cancer in the Donor Site After Breast Reconstruction With a Latissimus Dorsi Flap

Cited by 2 publications

References 0 publications

Supraclavicular Artery Island Flap: Critical Appraisal and Comparison to Alternate Reconstruction

Supraclavicular Artery Island Flap: Critical Appraisal and Comparison to Alternate Reconstruction

Lymphatic drainage study after latissimus dorsi flap breast reconstruction

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