Usefulness of a Lateral Thoracodorsal Flap after Breast Conserving Surgery in Laterally Located Breast Cancer

 

 Permissions and Reprints

Background Breast-conserving surgery is widely accepted as an appropriate method in breast cancer, and the lateral thoracodorsal flap provides a simple, reliable technique, especially when a mass is located in the lateral breast. This study describes the usefulness of a lateral thoracodorsal flap after breast conserving surgery in laterally located breast cancer.

Methods From September 2008 to February 2013, a lateral thoracodorsal flap was used in 20 patients with laterally located breast cancer treated at our institution. The technique involves a local medially based, wedge shaped, fasciocutaneous transposition flap from the lateral region of the thoracic area. Overall satisfaction and aesthetic satisfaction surveys were conducted with the patients during a 6-month postoperative follow-up period. Aesthetic results in terms of breast shape and symmetry were evaluated by plastic surgeons.

Results The average specimen weight was 76.8 g. The locations of the masses were the upper lateral quadrant (n=15), the lower lateral quadrant (n=2), and the central lateral area (n=3). Complications developed in four of the cases, partial flap necrosis in one, wound dehiscence in one, and fat necrosis in two. The majority of the patients were satisfied with their cosmetic outcomes.

Conclusions Partial breast reconstruction using a lateral thoracodorsal flap is well matched with breast color and texture, and the surgery is less aggressive than other techniques with few complications. Therefore, the lateral thoracodorsal flap can be a useful, reliable technique in correcting breast deformity after breast conserving surgery, especially in laterally located breast cancer.

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

Publication History

Received: 23 April 2013

Accepted: 19 June 2013

Article published online:
01 May 2022

© 2013. 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 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
  CrossrefPubMedGoogle Scholar
• 2 Veiga DF, Veiga-Filho J, Ribeiro LM. et al. Quality-of-life and self-esteem outcomes after oncoplastic breast-conserving surgery. Plast Reconstr Surg 2010; 125: 811-817
  CrossrefPubMedGoogle Scholar
• 3 Litiere S, Werutsky G, Fentiman IS. et al. Breast conserving therapy versus mastectomy for stage I-II breast cancer: 20 year follow-up of the EORTC 10801 phase 3 randomised trial. Lancet Oncol 2012; 13: 412-419
  CrossrefPubMedGoogle Scholar
• 4 Clough KB, Cuminet J, Fitoussi A. et al. Cosmetic sequelae after conservative treatment for breast cancer: classification and results of surgical correction. Ann Plast Surg 1998; 41: 471-481
  CrossrefPubMedGoogle Scholar
• 5 D'Aniello C, Grimaldi L, Barbato A. et al. Cosmetic results in 242 patients treated by conservative surgery for breast cancer. Scand J Plast Reconstr Surg Hand Surg 1999; 33: 419-422
  CrossrefPubMedGoogle Scholar
• 6 Slavin SA, Halperin T. Reconstruction of the breast conservation deformity. Semin Plast Surg 2004; 18: 89-96
  Article in Thieme ConnectPubMedGoogle Scholar
• 7 Yang JD, Kim MC, Lee JW. et al. Usefulness of oncoplastic volume replacement techniques after breast conserving surgery in small to moderate-sized breasts. Arch Plast Surg 2012; 39: 489-496
  Article in Thieme ConnectPubMedGoogle Scholar
• 8 Holmstrom H, Lossing C. The lateral thoracodorsal flap in breast reconstruction. Plast Reconstr Surg 1986; 77: 933-943
  CrossrefPubMedGoogle Scholar
• 9 Woerdeman LA, van Schijndel AW, Hage JJ. et al. Verifying surgical results and risk factors of the lateral thoracodorsal flap. Plast Reconstr Surg 2004; 113: 196-203
  CrossrefPubMedGoogle Scholar
• 10 Munhoz AM, Montag E, Arruda EG. et al. The role of the lateral thoracodorsal fasciocutaneous flap in immediate conservative breast surgery reconstruction. Plast Reconstr Surg 2006; 117: 1699-1710
  CrossrefPubMedGoogle Scholar
• 11 Alderman AK, Wilkins EG, Lowery JC. et al. Determinants of patient satisfaction in postmastectomy breast reconstruction. Plast Reconstr Surg 2000; 106: 769-776
  CrossrefPubMedGoogle Scholar
• 12 Veronesi U, Zurrida S. Breast conservation: current results and future perspectives at the European Institute of Oncology. Int J Cancer 2007; 120: 1381-1386
  CrossrefPubMedGoogle Scholar
• 13 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
  CrossrefPubMedGoogle Scholar
• 14 Clough KB. Keynote speech: Oncoplastic surgery. Presented at the RACS/CSHK Conjoint Annual Scientific Congress 2008 May Hong Kong
  Google Scholar
• 15 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
  CrossrefPubMedGoogle Scholar
• 16 Fitoussi AD, Berry MG, Fama F. et al. Oncoplastic breast surgery for cancer: analysis of 540 consecutive cases. Plast Reconstr Surg 2010; 125: 454-462
  CrossrefPubMedGoogle Scholar
• 17 Garcia EB, Sabino M, Ferreira LM. et al. Retalho toraco-axilar nareparacao imediata da quadrantectomia supero-lateral damama. Rev Bras Mastol 2000; 10: 185-191
  Google Scholar