Combination of two local flaps for large defects after breast conserving surgery

Area of Science:

• Oncology
• Plastic Surgery
• Breast Cancer Surgery

Background:

• Oncoplastic surgery aims to achieve wide excision of breast cancer while maintaining breast aesthetics.
• Large defects after partial mastectomy pose a reconstructive challenge, potentially impacting cosmetic outcomes.

Purpose of the Study:

• To evaluate the efficacy of a novel combined local flap technique for reconstructing large breast defects following oncoplastic surgery.
• To assess the cosmetic results of using a rotational local flap combined with a thoraco-epigastric flap (TEF).

Main Methods:

• A cohort of 21 breast cancer patients underwent partial mastectomy with immediate reconstruction using a combined local flap (rotational flap + TEF).
• Reconstruction was performed for positive surgical margins or larger-than-expected tumor sizes.
• Cosmetic outcomes were self-assessed post-chemotherapy and radiotherapy using a four-point scale.

Main Results:

• The mean patient age was 53.3 years, with a mean tumor size of 2.2 cm.
• The average excised breast volume was 133.8 mm³, representing 20.4% of the total breast volume.
• Cosmetic outcomes were rated as excellent in 11 patients, good in 8, and fair in 2.

Conclusions:

• The combined local flap, integrating a rotational flap and a TEF, is a viable and effective oncoplastic technique.
• This method addresses large defects resulting from breast-conserving surgery, offering favorable cosmetic results.