CC BY-NC 4.0 · Arch Plast Surg 2012; 39(05): 489-496
DOI: 10.5999/aps.2012.39.5.489
Original Article

Usefulness of Oncoplastic Volume Replacement Techniques after Breast Conserving Surgery in Small to Moderate-sized Breasts

Jung Dug Yang
Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, Daegu, Korea
,
Min Chul Kim
Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, Daegu, Korea
,
Jeong Woo Lee
Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, Daegu, Korea
,
Young Kyoo Cho
Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, Daegu, Korea
,
Kang Young Choi
Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, Daegu, Korea
,
Ho Yun Chung
Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, Daegu, Korea
,
Byung Chae Cho
Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, Daegu, Korea
,
Ho Yong Park
Department of Surgery, Kyungpook National University School of Medicine, Daegu, Korea
› Author Affiliations

Background In Korean women, many of whom have small to moderate-sized breasts, it is difficult to cover a partial breast defect using oncoplastic volume displacement techniques after removal of an adequate volume of tissue during oncologic surgery. In such cases, oncoplastic volume replacement techniques are more useful.

Methods From January 2007 to December 2011, 104 women underwent a total of 107 breast-conserving surgeries with various kinds of oncoplastic volume replacement techniques. We used latissimus dorsi (LD) myocutaneous flap for cases in which the resection mass was greater than 150 g. In case with a resection mass less than 150 g, we used regional flaps such as a lateral thoracodorsal flap, a thoracoepigastric flap, or perforator flaps such as an intercostal artery perforator (ICAP) flap or a thoracodorsal artery perforator (TDAP) flap.

Results The mean age was 46.1 years, and the average follow-up interval was 10.3 months. The patients underwent oncoplastic volume replacement techniques with a lateral thoracodorsal flap (n=9), thoracoepigastric flap (n=7), ICAP flap (n=25), TDAP flap (n=12), and LD flap (n=54). There was one case of congestion in an LD flap, and two cases of fat necrosis in an ICAP flap. Most of the patients were satisfied with the cosmetic results.

Conclusions Oncoplastic volume replacement techniques can be reliable and useful for the correction of breast deformity after breast-conserving surgery, especially in patients with small to moderate-sized breasts.

This research was supported by Kyungpook National University Research Fund, 2012.




Publication History

Received: 04 May 2012

Accepted: 26 July 2012

Article published online:
01 May 2022

© 2012. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • REFERENCES

  • 1 Shin HR, Jung KW, Won YJ. et al. 2002 annual report of the Korea Central Cancer Registry: based on registered data from 139 hospitals. Cancer Res Treat 2004; 36: 103-114
  • 2 Audretsch WP, Rezai M, Kolotas C. et al. Tumor-specific immediate reconstruction (TSIR) in breast cancer patients. Perspect Plast Surg 1998; 11: 71-100
  • 3 Yang JD, Bae SG, Chung HY. et al. The usefulness of oncoplastic volume displacement techniques in the superiorly located breast cancers for Korean patients with small to moderate-sized breasts. Ann Plast Surg 2011; 67: 474-480
  • 4 Alderman AK, Wilkins EG, Lowery JC. et al. Determinants of patient satisfaction in postmastectomy breast reconstruction. Plast Reconstr Surg 2000; 106: 769-776
  • 5 Veronesi U, Saccozzi R, Del Vecchio M. et al. Comparing radical mastectomy with quadrantectomy, axillary dissection, and radiotherapy in patients with small cancers of the breast. N Engl J Med 1981; 305: 6-11
  • 6 Fisher B, Bauer M, Margolese R. et al. Five-year results of a randomized clinical trial comparing total mastectomy and segmental mastectomy with or without radiation in the treatment of breast cancer. N Engl J Med 1985; 312: 665-673
  • 7 NIH consensus conference. Treatment of early-stage breast cancer. JAMA. 1991. 265. 391-395
  • 8 Anderson BO, Masetti R, Silverstein MJ. Oncoplastic approaches to partial mastectomy: an overview of volume-displacement techniques. Lancet Oncol 2005; 6: 145-157
  • 9 Bae SG, Yang JD, Lee SY. et al. Oncoplastic techniques for treatment of inferiorly located breast cancer. J Korean Soc Plast Reconstr Surg 2008; 35: 680-686
  • 10 Kaur N, Petit JY, Rietjens M. et al. Comparative study of surgical margins in oncoplastic surgery and quadrantectomy in breast cancer. Ann Surg Oncol 2005; 12: 539-545
  • 11 Clough KB, Lewis JS, Couturaud B. et al. Oncoplastic techniques allow extensive resections for breast-conserving therapy of breast carcinomas. Ann Surg 2003; 237: 26-34
  • 12 Holmstrom H, Lossing C. The lateral thoracodorsal flap in breast reconstruction. Plast Reconstr Surg 1986; 77: 933-943
  • 13 Huemer GM. Partial mastectomy: breast reconstruction with the pedicled thoracoepigastric flap. In: Fitzal F, Schrenk P. Oncoplastic breast surgery: a guide to clinical practice. 2010. Vienna: Springer; 127-132
  • 14 Hamdi M, Salgarello M, Barone-Adesi L. et al. Use of the thoracodorsal artery perforator (TDAP) flap with implant in breast reconstruction. Ann Plast Surg 2008; 61: 143-146
  • 15 Khoobehi K, Allen RJ, Montegut WJ. Thoracodorsal artery perforator flap for reconstruction. South Med J 1996; 89: S110