J Breast Cancer.  2023 Feb;26(1):35-45. 10.4048/jbc.2023.26.e8.

Surgical Strategies for Partial Breast Reconstruction in Medial-Located Breast Cancer: A 12-Year Experience

• Kang MJ
• Hong HK
• Eo PS
• Lee JS
• Lee JW
• Lee J
• Park HY
• Yang JD

• KMID: 2540044
• DOI: http://doi.org/10.4048/jbc.2023.26.e8

Abstract

Purpose
Partial breast reconstruction is challenging in medially located breast cancer, particularly in terms of achieving satisfactory aesthetic coverage. Thus, we aimed to investigate surgical strategies for filling medial defects resulting from breast-conserving surgery to improve patient satisfaction and aesthetic outcomes.
Methods
We retrospectively evaluated 113 patients (114 cases) with medially located breast cancer between 2007 and 2018. We analysed the patient data, such as breast size, specimen weight, complications, and aesthetic results obtained using a questionnaire.
Results
The mean body mass index and specimen weight were 23.43 kg/m² (range, 18.5–26.8) and 83.29 g (range, 15–290 g), respectively. The tennis racket and round-block techniques were chosen for small defects (< 10%–15%) in small- and medium-sized breasts. The rotational and perforator flap techniques were used for medium-sized defects. The latissimus dorsi (LD) flap technique was used for large defects (> 30%). Hematoma was found in 1 case (0.96%), linear skin necrosis was found in 1 case (0.96%), seroma in the LD flaps was found in 8 cases (7.69%); fat necrosis in the rotational flaps was found in 2 cases (1.92%); and fat necrosis in an anterior intercostal artery perforator flap was found in 1 case (0.96%). 91 patients (87.5%) were satisfied with the aesthetic results.
Conclusion
The techniques used in this study for medially located breast cancer can produce fine aesthetic outcomes with regard to breast size and resection volume, with few complications.

Keyword

Breast Neoplasms; Mastectomy; Segmental; Mammaplasty; Perforator Flap