Retrospective observational study of breast reconstruction with extended latissimus dorsi flap following skin-sparing mastectomy

Abstract

The study was aimed to evaluate oncological safety and patient satisfaction in relatively late stage breast cancer patients who was treated with skin-sparing mastectomy (SSM) followed by breast reconstruction with an extended latissimus dorsi (LD) flap. Oncological safety, postoperative complications, and cosmetic results were retrospectively analyzed in patients who underwent extended LD flap breast reconstruction following SSM between October 2011 and August 2014. A total of 62 patients who underwent 63 breast reconstructions were enrolled in the study. Local recurrence rate was 1.6% over a median follow-up of 63 months. On final aesthetic assessment, 37 reconstructions were rated excellent, 19 good, 5 fair, and 2 poor. Reconstruction-related complications occurred in 22 patients (34.9%); these patients’ satisfaction scores were significantly lower than those of patients without complications (P < .05). Five patients developed shoulder movement limitation, and 2 had minor twitching and pain in the reconstructed breast. However, these patients did not find their problems disabling and were able to live normally. SSM followed by breast reconstruction with extended LD flap can improve patients’ postoperative quality of life and is as oncologically safe as total mastectomy even in patients with tumors of relatively late stage.

Novel technique for endoscopic-assisted nipple-sparing mastectomy and immediate breast reconstruction with endoscopic-assisted latissimus dorsi muscle flap harvest through a single axillary incision: a retrospective cohort study of comparing endoscopic and open surgery

“…The traditional open technique has been described previously ( 24 ). It leaves a notable scar on the breast and back.…”

Oncological Safety of Skin-Sparing Mastectomy and Immediate Breast Reconstruction in Extensive Ductal Carcinoma In Situ

“…The overall number of skin necrosis is in concordance with the previous literature showing a necrosis rate of 0%-17%. [34][35][36][37][38] The dilemma is associated with the surgical technique of SSM, the thickness of skin flaps, and the amount of a residual breast tissue left especially on the anterior margin. Contradictory to each other, it has been shown that the skin flap thickness more than 5 mm increases the amount of residual breast tissue 39 and the flap thickness less than 5 mm increases the risk of skin necrosis.…”

Comparison of breast volume change between oncoplastic breast-conserving surgery with radiation therapy and a simultaneous contralateral balancing procedure through the inverted-T scar technique

“…In patients who have undergone breast reconstruction using an extended latissimus dorsi muscle flap decreased latissimus dorsi muscle mass after radiation therapy is frequently observed due to factors including muscle atrophy and fibrosis [9,10]. However, in BCS, as muscle tissue is not used for breast reconstruction, it is predicted that the amount of volume decrease would be relatively small.…”