Immediate reconstruction using a modified thoracodorsal adipofascial cutaneous flap after partial mastectomy
Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences 8-35-1, Sakuragaoka, Kagoshima 890-8520, Japan.Breast (Edinburgh, Scotland) (Impact Factor: 2.38). 05/2011; 20(5):464-7. DOI: 10.1016/j.breast.2011.05.001
The treatment of early breast cancer using breast conservation therapy (BCT) usually ensures local control and acceptable cosmetic results. We report a useful technique involving the use of a thoracodorsal adipofascial cutaneous flap for reconstructing defects in the upper-outer quadrant area after partial mastectomy that has achieved excellent results. We developed this procedure as an oncoplastic technique for treating a Japanese woman with a similar defect and a relatively slim body. In this procedure, partial mastectomy is followed by raising the anterior half of the flap via the same skin incision, and the posterior half is raised via an additional incision posterior to the axillary area to produce a crescent of de-epithelialized skin. A C-shaped flap containing a crescent of de-epithelialized skin composed of subcutaneous fat and the fascia of the latissimus dorsi muscle is then rotated, gathered, and inset into the breast defect.
Article: Update on oncoplastic breast surgery[Show abstract] [Hide abstract]
ABSTRACT: Oncoplastic surgery of the breast (OPS) has generated great excitement over the past years and has become an integrated component of the surgical treatment of breast cancer. Oncoplastic surgical procedures associate the best surgical oncologic principles to achieve wide tumor-free margins with the best principles of plastic surgery to optimize cosmetic outcomes. Thanks to oncoplastic techniques, the role of breast conserving surgery (BCS) has been extended to include a group of patients who would otherwise require mastectomy to achieve adeguate tumor clearance. As OPS continues to gain acceptance and diffusion, an optimal and systematic approach to these techniques is becoming increasingly necessary. This article has the aim to review the essential principles and techniques associated with oncoplastic surgery, based on the data acquired through an extensive search of the PUBMED and MEDLINE database for articles published using the key words "breast cancer oncoplastic surgery". This review analyzes possible the advantages", classifications, indications, and the criteria for a proper selection of oncoplastic techniques to facilitate one's ability to master these procedures and make OPS a safe and an effective procedure.
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ABSTRACT: The treatment of early breast cancer using breast-conserving therapy commonly ensures local control and acceptable cosmetic results. We herein report a useful technique, including the use of a thoracodorsal adipofascial cutaneous flap for reconstructing defects in the outer quadrant area after partial mastectomy, which achieved excellent results. We performed partial mastectomy followed by immediate volume replacement using a modified thoracodorsal adipofascial cutaneous flap with a crescent-shaped dermis in ten patients. The modified oncoplastic technique was performed without any complications in all patients. Sufficient blood flow to the cutaneous flap with the crescent-shaped dermis was visualized in two patients during the operation after the injection of indocyanine green. The oncological and cosmetic results were excellent to good in these patients. Oncoplastic surgery using a modified thoracodorsal adipofascial flap with a crescent-shaped dermis was successfully performed in patients with early cancer lesions in the outer quadrant, and the cosmetic results obtained were excellent.
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