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Breast reconstruction after failed conservation.

A G Nash, P R Taylor

    Annals of the Royal College of Surgeons of England
    |September 1, 1985
    PubMed
    Summary
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    Latissimus dorsi myocutaneous flaps offer a viable reconstruction option following breast cancer treatment failure. This study found no local recurrences in 29 patients after a mean 20.2-month follow-up, suggesting effectiveness for breast carcinoma.

    Area of Science:

    • Oncology
    • Plastic Surgery
    • Breast Reconstruction

    Background:

    • Breast cancer treatment failure can necessitate further surgical intervention.
    • Recurrent breast carcinoma and radiation necrosis pose reconstructive challenges.
    • Latissimus dorsi myocutaneous flaps are a surgical technique for breast reconstruction.

    Purpose of the Study:

    • To evaluate the efficacy of latissimus dorsi myocutaneous flaps in breast reconstruction after failed breast-conserving therapy for carcinoma.
    • To assess outcomes in patients undergoing latissimus dorsi reconstruction for recurrent breast tumors or radiation necrosis.
    • To report on local recurrence rates following this reconstructive approach.

    Main Methods:

    • Retrospective review of 29 patients treated with latissimus dorsi myocutaneous flaps.

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  • Two reconstruction methods were employed: total mastectomy with latissimus dorsi flap and silicone implant, or latissimus dorsi flap with nipple preservation.
  • Patients had either central recurrent tumors, radiation necrosis, or peripheral recurrent tumors.

    • Main Results:

    • No local recurrences were observed in any of the 29 patients during the mean follow-up period of 20.2 months.
    • Seventeen patients with central recurrence and three with radiation necrosis underwent mastectomy and reconstruction with a silicone implant.
    • Nine patients with peripheral recurrence had latissimus dorsi reconstruction with nipple preservation.

    Conclusions:

    • Latissimus dorsi myocutaneous flaps appear to be an effective method for breast reconstruction in cases of failed breast conservation for carcinoma.
    • The observed absence of local recurrence suggests a potentially favorable oncologic outcome, though longer follow-up is required.
    • This technique provides a reconstructive solution for diverse post-treatment breast defects, including recurrence and necrosis.