Oncoplastic breast surgery combining partial mastectomy with resection of double equilateral triangular skin flaps

AbstractThe treatment of early breast cancer using oncoplastic breast surgery (OBS) has been gradually increasing in popularity and is recognized for its efficacy in local control and excellent cosmetic results. We herein report a useful technique for obtaining symmetry of the breast shape for an early breast lesion located in an outer area, close to the nipple-areola, in a Japanese patient with ptotic, fatty breasts. We designed two equilateral triangles: one just upon the resected area and the other on the axilla. They were located on a straight line, with one top pointed to the cranial side and one to the caudal side. A crescent area around the areola was de-epithelialized in the 12 o’clock and 6 o’clock directions. Columnar-shaped breast tissue and an equilateral triangular skin flap and fatty tissue were removed together. To fill the defect, a skin-glandular flap was slid horizontally after suturing the inframammary line. Although an incision scar was formed on the breast and lateral chest wall in a Z-shape, this new technique was able to achieve not only cancer control but also excellent cosmetic results.

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Oncoplastic breast surgery combining partial mastectomy with immediate breast reshaping using multiple local flaps for a patient with slim body

Breast Cancer ◽

10.1007/s12282-019-00948-5 ◽

2019 ◽

Vol 26 (4) ◽

pp. 529-534

Author(s):

Yuko Kijima ◽

Munetsugu Hirata ◽

Yoshiaki Shinden ◽

Toshiaki Utsumi ◽

Zenichi Morise ◽

...

Keyword(s):

Breast Surgery ◽

Partial Mastectomy ◽

Local Flaps ◽

Oncoplastic Breast Surgery ◽

Breast Reshaping

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Thoracodorsal Artery Perforator and Superior Epigastric Artery Perforator Flaps for Volume Replacement Oncoplastic Breast Surgery

Indian Journal of Plastic Surgery ◽

10.1055/s-0039-3400688 ◽

2019 ◽

Vol 52 (03) ◽

pp. 304-308

Author(s):

Dushyant Jaiswal ◽

Prabha Subhash Yadav ◽

Vinay Kant Shankhdhar ◽

Tasneem Jaffer Belgaumwala

Keyword(s):

Breast Surgery ◽

Breast Conservation ◽

Volume Replacement ◽

Partial Mastectomy ◽

Perforator Flaps ◽

Oncoplastic Breast Surgery ◽

Skin Paddle ◽

Epigastric Artery ◽

Thoracodorsal Artery ◽

Artery Perforator

Abstract Introduction Breast conservation therapy (BCT) and oncoplastic breast surgery (OBS) are now established modalities of treatment for breast cancer, with proven oncological safety. Traditionally, latissimus dorsi (LD) flaps have been the one-stop solution workhorse when volume replacement is needed. We present our experience with thoracodorsal artery perforator (TDAP) and superior epigastric artery perforator (SEAP) flaps. These flaps allow the preservation of muscle structure and function. Material and Methods Data were collected prospectively of patients in whom pedicled perforator flaps after BCT were used. A handheld 8-MHz audio Doppler was used to locate the perforators. TDAP flaps were used in four patients, whereas SEAP flaps were used in two patients. Skin paddle sizes ranged from 10 × 3 cm to 21 × 7 cm. Results TDAP flaps were used in four patients, whereas SEAP flaps were used in two patients All flaps survived. No flap had partial necrosis or fat necrosis. All donor sites were closed primarily and healed uneventfully, and none had a seroma requiring aspiration. Conclusion TDAP flaps can be selectively employed when the LD muscle function needs to be preserved. SEAP flaps can also be employed as a rare option in case of lower inner quadrant defects. Pedicled perforator flaps are a useful and reliable option for volume replacement OBS in select patients for reconstructing partial mastectomy defects.

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Oncoplastic breast surgery combining partial mastectomy with a triangular skin resection and re-centralization of the nipple-areola

Surgery Today ◽

10.1007/s00595-020-02041-3 ◽

2020 ◽

Vol 50 (12) ◽

pp. 1707-1711 ◽

Cited By ~ 1

Author(s):

Yuko Kijima ◽

Munetsugu Hirata ◽

Naotomo Higo ◽

Hiroko Toda ◽

Zenichi Morise ◽

...

Keyword(s):

Breast Surgery ◽

Partial Mastectomy ◽

Oncoplastic Breast Surgery

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Lateral chest wall perforator flaps in partial breast reconstruction

Journal of the Egyptian National Cancer Institute ◽

10.1186/s43046-021-00100-5 ◽

2022 ◽

Vol 34 (1) ◽

Author(s):

Ahmed Orabi ◽

Mina M G Youssef ◽

Tamer M. Manie ◽

Mohamed Shaalan ◽

Tarek Hashem

Keyword(s):

Breast Reconstruction ◽

Chest Wall ◽

Operative Time ◽

Standard Procedure ◽

Cosmetic Outcome ◽

Partial Mastectomy ◽

Perforator Flaps ◽

Oncoplastic Breast Surgery ◽

Lateral Chest ◽

Artery Perforator

Abstract Background Breast conserving surgery (BCS) has been a standard procedure for the treatment of breast cancer instead of mastectomy whenever possible. Lateral chest wall perforator flaps are one of the volume replacement techniques that participate in increasing the rate of BCS especially in small- to moderate-sized breasts with good cosmetic outcome. In this study, we tried to evaluate the outcome of those flaps as an oncoplastic procedure instead of the conventional flaps. Methods This study included 26 patients who underwent partial mastectomy with immediate reconstruction using lateral chest wall perforator flaps in the period from October 2019 to November 2020. The operative time, techniques, and complications were recorded. The cosmetic outcome was assessed 3 months post-radiation therapy through a questionnaire and photographic assessment. Results Lateral intercostal artery perforator (LICAP), lateral thoracic artery perforator (LTAP) and combined flaps were performed in 24, 1, and 1 patients, respectively. The mean operative time was 129.6 ± 13.2 min. The flap length ranged from 10 to 20 cm and its width from 5 to 9 cm. Overall patients’ satisfaction was observed to be 88.5% as either excellent or good and the photographic assessment was 96.2% as either excellent or good. Conclusions Lateral chest wall perforator flaps are reliable and safe option for partial breast reconstruction with an acceptable aesthetic outcome. In the era of oncoplastic breast surgery, they deserve to gain attention especially with the advantages of some modifications added to the classic technique.

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