J Breast Cancer.
2023 Aug;26(4):344-352. 10.4048/jbc.2023.26.e33.
Comparison of Quality of Life and Cosmetic Outcome of Latissimus Dorsi Mini-Flap With Breast Conservation Surgery Without Reconstruction
- Affiliations
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- 1Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
- 2Department of Surgery, Seoul Metropolitan Government Seoul National University, Boramae Medical Center, Seoul, Korea
- 3Department of Surgery, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
- 4Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
- 5Department of Surgery, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
- 6Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea
- 7Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
- 8Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
- KMID: 2545767
- DOI: http://doi.org/10.4048/jbc.2023.26.e33
Abstract
- Purpose
Latissimus dorsi mini-flap (LDMF) reconstruction after breast-conserving surgery (BCS) is a useful volume replacement technique when a large tumor is located in the upper or outer portion of the breast. However, few studies have reported the impact of LDMF on patients’ quality of life (QoL) and cosmesis compared with conventional BCS.
Methods
We identified patients who underwent BCS with or without LDMF between 2010 and 2020 at a single center. At least 1 year after surgery, we prospectively administered the BREAST-Q to assess QoL and obtained the patients’ breast photographs. The cosmetic outcome was assessed using four panels composed of physicians and the BCCT.core software.
Results
A total of 120 patients were enrolled, of whom 62 and 58 underwent LDMF or BCS only, respectively. The LDMF group had significantly larger tumors, shorter nipple-to-tumor distances in preoperative examinations, and larger resected breast volumes than did the BCSonly group (p < 0.001). The questionnaires revealed that QoL was poorer in the LDMF group, particularly in terms of the physical well-being score (40.9 vs. 20.1, p < 0.001). Notably, the level of patients’ cosmetic satisfaction with their breasts was comparable, and the cosmetic evaluation was assessed by panels and the BCCT.core software showed no differences between the groups.
Conclusion
Our results showed that cosmetic outcomes of performing LDMF are comparable to those of BCS alone while having the advantage of resecting larger volumes of breast tissue. Therefore, for those who strongly wish to preserve the cosmesis of their breasts, LDMF can be considered a favorable surgical option after the patient is oriented toward the potential for physical dysfunction after surgery.
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