Usefulness of breast-volume replacement using an inframammary adipofascial flap after breast-conservation therapy

Ogawa, Tomoko; Hanamura, Noriko; Yamashita, M; Ri, Y.; Kuriyama, Naohisa; Isaji, Shuji

doi:10.1016/j.amjsurg.2006.07.018

Cited by 36 publications

(26 citation statements)

References 14 publications

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“…Ogawa et al [9] stated that it is more difficult to repair defects in the lower portion of the breast than defects in the upper portion of the breast.…”

Section: Discussionmentioning

confidence: 99%

“…Immediate breast reconstruction with adipofascial flaps has become a safe option for patients with early-stage breast carcinoma [9,11]. It can also be used to cover implants [12].…”

Section: Introductionmentioning

confidence: 99%

“…Ogawa et al [9] emphasized that BCT has become the standard strategy for breast cancer surgery ensuring local control with acceptable cosmetic results. Agarwal et al [10] reported that patients who underwent BCT had a higher breast cancer-specific survival rate compared with those treated with mastectomy for early-stage invasive ductal carcinoma.…”

Section: Introductionmentioning

confidence: 99%

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New possible surgical approaches for the submammary adipofascial flap based on its arterial supply

Elzawawy

Kelada

Alkarmouty

2016

European Journal of Surgical Oncology (EJSO)

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Introduction. Submammary adipofascial flap (SMAF) is a valuable option for replacement of the inferior portion of the breast. It is particularly useful for reconstruction of partial mastectomy defects. It is also used to cover breast implants. Most surgeons base this flap cranially on the submammary skin crease, reflecting it back onto the breast. The blood vessels supplying this flap are not well defined, and the harvest of the flap may be compromised due to its uncertain vascularity. The aim of the work was to identify perforator vessels supplying SMAF and define their origin, site, diameter, and length. Materials and Methods. The flap was designed and dissected on both sides in 10 female cadavers. SMAF outline was 10 cm in length and 7 cm in width. The flap was raised carefully from below upwards to identify the perforator vessels supplying it from all directions. These vessels were counted and the following measurements were taken using Vernier caliper: diameter, total length, length inside the flap, and distance below the submammary skin crease. Conclusions. The perforators at the lateral part of the flap took origin from the lateral thoracic, thoracodorsal, and intercostal vessels. They were significantly larger, longer, and of multiple origins than those on the medial part of the flap and this suggests that laterally based flaps will have better blood supply, better viability, and more promising prognosis. Both approaches, medially based and laterally based SMAF, carry a better prognosis and lesser chance for future fat necrosis than the classical cranially based flap.

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“…Ogawa et al [9] stated that it is more difficult to repair defects in the lower portion of the breast than defects in the upper portion of the breast.…”

Section: Discussionmentioning

confidence: 99%

“…Immediate breast reconstruction with adipofascial flaps has become a safe option for patients with early-stage breast carcinoma [9,11]. It can also be used to cover implants [12].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

New possible surgical approaches for the submammary adipofascial flap based on its arterial supply

Elzawawy

Kelada

Alkarmouty

2016

European Journal of Surgical Oncology (EJSO)

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“…Therefore, the resection lines were modified using information obtained by supine MRM. We planned on using an inframammary adipofascial flap [9] to cosmetically repair the defect created by the partial mastectomy (Fig. 5).…”

Section: Case Reportmentioning

confidence: 99%

New preoperative MRI marking technique for a patient with ductal carcinoma in situ

et al. 2008

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We herein present a case of non-palpable ductal carcinoma in situ (DCIS) treated with successful breast-conserving surgery (BCS) using MR markers made with commercially available materials in the supine position. The patient was a 40-year-old woman found to have a non-mass lesion by routine screening ultrasonography (US). The margin of the lesion was unclear by the US examination, whereas contrast-enhanced MR mammography (MRM) revealed a clear margin of the lesion. After the resection line was determined by under US guidance, the area was marked by original markers for MRI using the pills of Breath Care inside a Penrose drain. MRM was performed in the supine position (supine MRM), which is similar to the posture used for surgery. The lesion was located within the resection area, but it was not at the center of the resection area; thus, the resection lines were modified using information obtained by MRM. The histological evaluation of the BCS specimen demonstrated a wide extension of the DCIS. The lesion was located at the center of the resection specimen, and the surgical margin was free. In conclusion, since our procedure can be performed easily, it is useful for evaluating the extent of the lesion as determined by the US examination in difficult cases.

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“…However, while many oncoplastic techniques are suitable for large breasts, many Japanese females have small and dense glandular breasts. We have therefore developed two oncoplastic techniques [3-5] for the breast-conserving reconstruction of small breasts.…”

Section: Introductionmentioning

confidence: 99%

Oncoplastic Technique Combining an Adipofascial Flap with an Extended Glandular Flap for the Breast-Conserving Reconstruction of Small Dense Breasts

et al. 2012

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We introduce a method combining two oncoplastic techniques for breast-conserving reconstruction. The procedure is as follows: first, an extended glandular flap is made by undermining the breast from both the skin and the pectoralis fascia to the upper edge of the breast at the subclavicular area. After modeling the breast mound with the extended glandular flap, an inframammary adipofascial flap is made. The flap is reflected back to the breast area remodeled using the extended glandular flap. After reshaping the breast, the inframammary line is then re-shaped. This method is indicated for patients with breast cancer in the outer portion of the breast, who have small dense breasts, and have undergone a large excision of about 40% of their breast volume. We treated four patients, all of whom had either excellent or good cosmetic results with no fat necrosis.

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Usefulness of breast-volume replacement using an inframammary adipofascial flap after breast-conservation therapy

Cited by 36 publications

References 14 publications

New possible surgical approaches for the submammary adipofascial flap based on its arterial supply

New possible surgical approaches for the submammary adipofascial flap based on its arterial supply

New preoperative MRI marking technique for a patient with ductal carcinoma in situ

Oncoplastic Technique Combining an Adipofascial Flap with an Extended Glandular Flap for the Breast-Conserving Reconstruction of Small Dense Breasts

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