Oncoplastic Reconstruction with Superior Based Lateral Breast Rotation Flap after Lower Quadrant Tumor Resection

Abstract

PurposePoor cosmetic outcome have been reported as a result of breast cancer operation due to lower quadrant breast tumors; this is particularly true for women with small, firm breasts. Herein, we report here on the use of superior based lateral breast rotation flap reconstruction to improve cosmetic outcome in patients with lower quadrant breast cancer.MethodsWe enrolled 33 patients with invasive breast cancer located in the lower quadrant of the breast, which were located more than 2 cm apart from the nipple. After completing a quadrantectomy, a single S-shaped or reverse S-shaped incision was made from axilla to tumor site. Two triangular skin islands, one on the axilla and one overlying the tumor were marked for excision. Once the fibroglandular tissues and the additional fatty tissue of the lateral chest wall were appropriately mobilized, the breast defect was closed at the mid-point of the parenchymal thickness in order to keep the natural position of the infra mammary fold.ResultsMedian tumor size was 2.3 cm (range, 0.7-3.5 cm) and median resected volume was 35.5 g (range, 27.0-51.0 g). With a mean follow-up of 24.5 months (range, 9.0-33.5 months), cosmetic outcomes were good (94.0%) to fair (6.0%) at 6 months after the procedure, and there was no local or systemic recurrence during the short term follow-up period.ConclusionClearly, this type of rotation flap reconstruction is an oncologically safe and a cosmetically sound procedure. Hopefully this rotation flap reconstruction technique will become more widely available and perhaps a standard procedure for lower quadrant breast tumors, especially for cosmetic treatment of small to medium-sized breasts.

Outcome reporting in therapeutic mammaplasty: a systematic review

“…Some investigators assessed aesthetic outcome after adjuvant therapy, at 6 months ( n = 4) 42 , 45 , 70 , 138 , 12 months ( n = 1) 134 , regular intervals ( n = 2) 38 , 103 , within a reported range of measurement points ( n = 2) 90 , 106 or at an unspecified time afterwards ( n = 4) 58 , 85 , 120 , 129 . Kim and colleagues, measured aesthetic outcome at 6 months after operation or after chemoradiation 125 , if this finished later than 6 months after surgery.…”

Breast segmentectomy with rotation mammoplasty as an oncoplastic approach to extensive ductal carcinoma in situ

“…In none of the cases, cosmetic result 6 months after surgery was assessed as poor. Cosmesis was good (94 %) to fair (6 %) according to sum of scores of symmetry, breast shape, scarring, and NAC position [ 25 ]. Good cosmetic outcomes from this series are in concordance with our study.…”

Locoregional flaps in oncoplastic surgery and breast reconstruction

“…In the present study, local and regional rotation flaps were used to mobilize the dermo-glandular flap toward the defect caused by quadrantectomy, aiming to repair it completely. These techniques are called volume displacement techniques, and are used in immediate repair in the conservative treatment of the breast 4,11 . They generally present a lower risk of complications than volume replacement techniques after total mastectomy 1,11 .…”

“…These techniques are called volume displacement techniques, and are used in immediate repair in the conservative treatment of the breast 4,11 . They generally present a lower risk of complications than volume replacement techniques after total mastectomy 1,11 . Surgical margins free of neoplasia correspond to a reduction in the risk of local recurrence, independently of margin size 4,8 .…”