Outcome Analysis of Breast Conserving Surgery with Latissimus Dorsi Flap Replacement
Keywords:
Breast conserving surgery, Latissimus Dorsi Flap, early stage breast cancerAbstract
Background/Objective: Breast conserving surgery (BCS) is an acceptable treatment for early stage breastcancer patients. Latissimus dorsi (LD) myocutaneous flap has been performed to replace significant defect
after BCS with an aim to optimize cosmetic outcome.1-3 Here we reviewed the outcome of BCS with LD flap
reconstruction in term of cosmetics and oncologic safety.
Patients and Methods: Between January 2008 and March 2010, 28 patients underwent BCS with LD flap
reconstruction at the Udonthani Cancer Center. Patients’ demographic data, surgical techniques and
complications, cosmetic results and oncologic outcomes were analyzed.
Results: We evaluated final esthetic cosmetic results of patients who underwent BCS with LD flap
reconstruction. The outcomes were reported as excellent, good and fair in 22 patients (78.5%), 5 patients
(17.7%) and 1 patient (3.5%) respectively. The most common operative complication was seroma formation in
20 patients (71.4%). In term of oncologic outcome, one patient had local recurrence and one patient had distant
metastasis. The local recurrence rate was correlated with positive surgical margin.
Conclusion: BCS with LD flap is an alternative surgical procedure to correct deformity with good
cosmetic result and acceptable oncologic outcome.
References
1. Bradon J, et al. Breast reconstruction. Sabiston Textbook of
Surgery. 17th Edition 2004;33:937.
2. Delay E, Nicolas G, And B, Patrick Z, Michel R. Autologous
latissimus breast reconstruction: a 3-year clinical experience
with 100 patients. American Society of Plastic Surgeons.
Volume 102(5), October 1998. p 1461-78.
3. Modena S, et al. Breast reconstruction with the latissimus
dorsi myocutaneous flap, Oncoplastic and reconstructive
surgery of the breast; 2004. p. 63.
4. Clough KB, Louis-Sylvestre C, Fitoussi A, et al. Donor site se
guelae after autologous breast reconstruction with an
extended latissimus dorsi flap. Plastic reconstruction with an
extended latissimus dorsi flap. Plast Reconstr Surg
2002;109:1904-11.
5. Cohen BE, Cronin ED. Breast reconstruction with the latissimus
dorsi musculocutaneous flap. Clin Plast Surg 1984; 11:287-
302.
6. Assessment of combined shoulder and elbow function The
America shoulder and Elbow surgeons scoring system,Clinical
orthopaedic examination. 5th edition. 2007. p. 57.
7. Youwanush K, Chirappapha P. Breast cancer: oncologic
and reconstructive surgery, Abstract presentation “Oneyear
follow-up of mastectomy with immediate ld flap
reconstruction by the extended ld flap technique”, June 18-
20. Milan, Italy: European Institute of Oncology; 2007. p. 38,
8. Bailcy MH, Smith JW, Casas L, et al. Immediate breast
reconstruction: reducing the risks. Plast Reconstr Surg 1989;
83:845-51.
9. McCraw JB, et al. The autogenous latissimus breast
reconstruction. Clin Plastic Surg 1994;21:279.
10. Ratanawichitrasin A, Rojananin S, Bhothisuwan K, et al.
Head Neck and Breast Surgery 2004;13:178-9.
11. Foster R, et al. Skin-sparing mastectomy and immediate
breast reconstruction: a prospective cohort study for
treatment of advance stages of breast carcinoma. Ann
Surg Oncol 2002;9:462-6.
Surgery. 17th Edition 2004;33:937.
2. Delay E, Nicolas G, And B, Patrick Z, Michel R. Autologous
latissimus breast reconstruction: a 3-year clinical experience
with 100 patients. American Society of Plastic Surgeons.
Volume 102(5), October 1998. p 1461-78.
3. Modena S, et al. Breast reconstruction with the latissimus
dorsi myocutaneous flap, Oncoplastic and reconstructive
surgery of the breast; 2004. p. 63.
4. Clough KB, Louis-Sylvestre C, Fitoussi A, et al. Donor site se
guelae after autologous breast reconstruction with an
extended latissimus dorsi flap. Plastic reconstruction with an
extended latissimus dorsi flap. Plast Reconstr Surg
2002;109:1904-11.
5. Cohen BE, Cronin ED. Breast reconstruction with the latissimus
dorsi musculocutaneous flap. Clin Plast Surg 1984; 11:287-
302.
6. Assessment of combined shoulder and elbow function The
America shoulder and Elbow surgeons scoring system,Clinical
orthopaedic examination. 5th edition. 2007. p. 57.
7. Youwanush K, Chirappapha P. Breast cancer: oncologic
and reconstructive surgery, Abstract presentation “Oneyear
follow-up of mastectomy with immediate ld flap
reconstruction by the extended ld flap technique”, June 18-
20. Milan, Italy: European Institute of Oncology; 2007. p. 38,
8. Bailcy MH, Smith JW, Casas L, et al. Immediate breast
reconstruction: reducing the risks. Plast Reconstr Surg 1989;
83:845-51.
9. McCraw JB, et al. The autogenous latissimus breast
reconstruction. Clin Plastic Surg 1994;21:279.
10. Ratanawichitrasin A, Rojananin S, Bhothisuwan K, et al.
Head Neck and Breast Surgery 2004;13:178-9.
11. Foster R, et al. Skin-sparing mastectomy and immediate
breast reconstruction: a prospective cohort study for
treatment of advance stages of breast carcinoma. Ann
Surg Oncol 2002;9:462-6.
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Published
2012-12-28
How to Cite
1.
Ingsirorat R. Outcome Analysis of Breast Conserving Surgery with Latissimus Dorsi Flap Replacement. Thai J Surg [Internet]. 2012 Dec. 28 [cited 2024 Apr. 20];33(4). Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/227066
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Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.
