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Oncoplastic Breast Surgery in Low-Resource Settings: Feasibility, Adoption and Outcomes of Local Perforator Flaps
Sanjay Kumar Yadav1, Ashwin S2, Goonj Johri3
1Department of Surgery, NSCB Medical College and Hospital, Jabalpur, India.
Abstract:
Oncoplastic breast surgery (OPBS) has advanced with local perforator flaps (LPFs), improving cosmetic outcomes in breast-conserving surgery (BCS). However, LPFs remain underutilized in low-resource settings. We evaluated the feasibility, adoption and outcomes of LPFs in a resource-limited setting. A retrospective study of 28 patients undergoing OPBS with LPF reconstruction was conducted at a single low-resource center. Flap selection was based on defect size, tumor location, and patient anatomy. Demographic and perioperative data, including operative time, complications, and adoption trends, were analyzed. All 28 procedures were completed without secondary reconstruction. Mean operative time was 115 ± 20 min, reducing by 13.5% over sequential cases, demonstrating a learning curve. Minor complications occurred in 10.7% of cases, with one flap loss. Cosmetic outcomes were satisfactory in 89.3% of patients. LPF adoption in OPBS cases increased from 12% in the first year to 33% by the third year, with a Total Adoption Score of 70.99%. LPF-based reconstruction is a feasible, reproducible technique for BCS in low-resource settings, with a clear institutional learning curve and increasing adoption.
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