TITLE:
Latissimus Dorsi Mini-Flap as a Volume Replacement Technique after Partial Mastectomy for Breast Cancer in the Upper and Central Breast Quadrants: A Single Center Experience
AUTHORS:
Waleed Elnahas, Ashraf Khater, Mohamed Hamdy, Emadeldeen Hamed, Osama Eldamshety, Mohamed Hegazy
KEYWORDS:
Oncoplastic, Breast Surgery, Latissimus Dorsi Mini-Flap, Conservative Surgery
JOURNAL NAME:
Surgical Science,
Vol.7 No.11,
October
27,
2016
ABSTRACT: Background: The latissimus dorsi (LD) muscle flap
plays an essential role in breast reconstruction after partial mastectomy for
cancer because of its stability and versatility. We evaluated both oncologic
and aesthetic outcomes in addition to the related complications of this flap as
an adjunct to breast conserving surgery in the management of breast cancer
patients. Methods: All patients underwent a one-stage
procedure with immediate reconstruction through two-steps operation; wider local
excision utilizing oncoplastic principles and mini flap harvest & volume
replacement. Results: The study included 34 cases with
early breast cancer; 30 patients had partial breast resection and defect
refilling by LD mini-flap, three patients underwent mastectomy and one patient
underwent extended LDF. The mean defect volume was (212.63 cm3 ± 59.57) cm3, while the mean flap volume was (218.27 cm3 ± 53.64 cm3). Patient self-evaluation of the cosmetic outcome was
excellent in 20%, good in 60% and satisfactory in 20% of patients. Panel
evaluation according to Harvard scale showed excellent in 36.7%, good in 36.7%,
fair in 26.7% of patients. The median hospital stay was 4 days. The
postoperative complications included wound gap in 4 patients (13.3%),
postoperative donor site seroma in 16 patients (53.3%). No flap loss or
necrosis, no affection on arm or shoulder mobility occurred. Lastly, no tumor
recurrence till now. Conclusion: Latissimus dorsi mini-flap can
achieve adequate cosmetic and oncologic outcomes with a low incidence of
complications in patients with early stage (I/II) breast cancer and small to
medium sized breasts.