Short Stay Management of Locally Advanced Breast Cancer Using Immediate Local Thoracoabdominal Advancement Flap and...

Area of Science:

• Surgical Oncology
• Plastic and Reconstructive Surgery
• Breast Cancer Treatment

Background:

• Locally advanced invasive breast cancer (LABC) often necessitates mastectomy with complex chest wall reconstruction.
• Anticipated chest wall defects can render LABC patients inoperable.
• The thoracoabdominal advancement flap (TAAF) presents a viable reconstruction solution.

Purpose of the Study:

• To evaluate the efficacy of immediate chest wall reconstruction using TAAF after mastectomy in LABC patients.
• To assess the feasibility of TAAF as an outpatient procedure.
• To analyze the impact of Enhanced Recovery After Surgery (ERAS) protocols on hospital stay.

Main Methods:

• Retrospective chart review of 13 LABC patients undergoing mastectomy with skin resection and TAAF reconstruction.
• Minimum 3-month follow-up period.
• Inclusion of patients managed with ERAS post-operative protocol.

Main Results:

• Successful immediate chest wall reconstruction in all 13 patients using TAAF.
• Mean hospital stay reduced to 1.3 nights with ERAS protocol.
• Low complication rate (1 post-op hematoma) and short operative time.
• Nine patients initiated adjuvant therapy within an average of 32 days post-surgery.

Conclusions:

• TAAF reconstruction is a reliable, durable, and outpatient procedure for immediate chest wall coverage post-mastectomy in LABC.
• The technique offers minimal donor site morbidity, allowing for delayed breast reconstruction.
• TAAF facilitates timely adjuvant therapy due to its low complication rate and short recovery.