Chest wall perforator flaps for partial breast reconstruction: Surgical outcomes from a multicenter study

Area of Science:

• Oncoplastic surgery
• Plastic and reconstructive surgery
• Breast surgery

Background:

• Perforator artery flaps, utilizing intercostal or lateral thoracic arteries, are available for breast-conserving surgery (BCS) reconstruction.
• Despite being described over a decade ago, these techniques have seen limited clinical adoption.
• This study evaluates surgical outcomes of partial breast reconstruction using chest wall perforator flaps.

Purpose of the Study:

• To assess the short-term and long-term surgical outcomes of partial breast reconstruction using chest wall perforator flaps.
• To evaluate the feasibility and safety of these flaps in a multicenter setting.

Main Methods:

• A prospective multicenter audit included 112 patients undergoing BCS with partial breast reconstruction using intercostal artery perforator or lateral thoracic artery perforator flaps between January 2015 and October 2018.
• Tumor excisions and reconstructions were performed as a single-stage procedure by trained oncoplastic breast surgeons.
• Surgical outcomes, including margin re-excision and complication rates, were recorded.

Main Results:

• 112 patients underwent the procedure, with a median age of 54 years.
• 13.39% of patients required margin re-excision without additional morbidity; one patient needed a completion mastectomy.
• Early complications occurred in 7.14% of patients, with no need for contralateral symmetrization procedures. Results were consistent across centers.

Conclusions:

• Chest wall artery perforator-based flaps are a highly effective option for lateral and inferior quadrant partial breast reconstruction.
• The surgical outcomes are favorable in both the short and long term, with minimal morbidity and consistent results across different centers.
• Further research into patient-reported outcome measures is warranted.