Effects of tamoxifen on survival of cutaneous and myocutaneous flap (experimental study)

Breast cancer is the most common non-skin malignancy in women. In breast cancer, the basic principle of endocrine therapy is to deprive tumor cell from the growth-stimulating effect of estrogens. The oldest, best-known and most widely used endocrine therapy medicine is tamoxifen, which is a selective estrogen receptor blocker. All factors that are known to have adverse effects on flap and pre-reconstruction flap survive should be eliminated 3 weeks before the surgery and started at the end of the 3rd week after the surgery. When the literature is reviewed, there are limited studies about that tamoxifen increases the risk of deep vein thrombosis and pulmonary embolism. The aim of this study was to research whether tamoxifen had adverse effects on the skin flap and muscle-skin flap survive.

In this study, 32 female Sprague-Davley rats were used. Their weights ranged from 220 to 250 g. 4 groups, each consisting of 8 rats, were formed. In this experimental study, in which rat models were used caudal based rat dorsal skin flap and superior pedicle rectus abdominis musculocutaneous flaps were applied. Control groups were formed for both flap models. Study groups were treated with tamoxifen citrat and control groups were treated with placebo.

As a result of the statistical evaluation done by measuring the surviving flap areas, it was found out that tamoxifen had no negative effect on flap survive.

Based on these findings, it was concluded that there was no need to stop tamoxifen as long as 6-7 weeks in patients undergoing breast reconstruction with pedicle flap techniques.