[Latissimus dorsi for autologous volume substitution in defects after breast saving therapy]

The present paper is based on the prospective data on breast conserving therapy recorded since 1977 in the "Basel protocol". Here both surgical and radio-oncological procedures are standardized, and a form sheet is provided for registering the pathological findings. Since our data showed that local recurrence free survival of patients treated by tumor resection only just in sano or questionably in sano was statistically significantly worse, it was decided to fill the volume defect occurring during breast conserving therapy with autologous tissue, in selected cases. Also an adjuvant radiation therapy was performed. Since January. 1st, 1992 we performed volume substitution by a latissimus dorsi flap in 27 patients treated by a surgically "enlarged" breast conserving concept. A classical skin muscle island, a deepithelized skin muscle island or a mere muscle island flap were performed. Aim of this pilot study was to further optimize early and late cosmetic results, to enlarge indication for breast conserving therapy and improve loco-regional tumor control.