Delayed breast reconstruction with transverse latissimus dorsi myocutaneous flap using Becker expander implants in patients submitted to radiotherapy: A series of cases

Dutra, Alexandre Katalinic; Abdala, Joel; Fernandes, Ana Cibele Nagae

doi:10.1016/j.bjps.2019.02.023

Cited by 2 publications

(1 citation statement)

References 28 publications

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“…Many patients who undergo SSM/NSM simultaneously with breast reconstruction receive either POCTx or radiotherapy (7,8); therefore, building upon previous studies, this study aimed to investigate the degree of atrophy of the latissimus dorsi muscle resulting from POCTx. Recently, it has become common for most patients to receive reconstruction using only implants or reconstruction with an eLDMC flap following partial mastectomy (breast conserving surgery).…”

Section: Discussionmentioning

confidence: 99%

Volumetric changes of the latissimus dorsi muscle after postoperative chemotherapy in cases of immediate breast reconstruction with an extended latissimus dorsi musculocutaneous flap and implant

et al. 2019

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Background: This study aimed to evaluate the volume reduction of latissimus dorsi muscle in patients who underwent immediate breast reconstruction using extended latissimus dorsi musculocutaneous (eLDMC) flap with implant after skin/nipple sparing mastectomy (SSM/NSM) and postoperative chemotherapy (POCTx).Methods: We retrospectively reviewed clinical records of 19 patients who underwent this surgery with POCTx, and checked chest computer tomography (CT) at 7-10 days after surgery and 6-14 months after the end of chemotherapy, from May 2015 to October 2016. The motor nerve to latissimus dorsi muscle was severed in all patient. One plastic surgeon intervened and the follow up period was at least 18 months.Author obtained the area of latissimus dorsi muscle using the Picture Archiving and Communication System (PACS) in the axial view of the chest CT and it was verified by the experienced radiologist. The statistical test was performed (P<0.05).Results: There was statistically decrease in latissimus dorsi muscle volume after the end of POCTx, range from 51.5-77.5%, average volume decrease was 62%, compared with latissimus dorsi muscle volume of the CT taken 7-10 days postoperatively (P<0.05). After a minimum follow-up period of 18 months, 14 of the 19 cases were satisfactory for both the surgeon and the patient. In 4 patients, breast volume was symmetrical when wearing bra, but the outline of the 90 cc implant was unfavorable. One patient had a smaller size of reconstructed breast than the other. Conclusions:The size of the implant should be determined considering that average latissimus dorsi muscle reduction is 62%. Especially, the size of the implant should be chosen carefully if latissimus dorsi muscle is thick or it occupies a large portion of the entire flap.

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Section: Discussionmentioning

confidence: 99%

Volumetric changes of the latissimus dorsi muscle after postoperative chemotherapy in cases of immediate breast reconstruction with an extended latissimus dorsi musculocutaneous flap and implant

et al. 2019

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Delayed breast reconstruction with the thoracodorsal flap and endoprosthesis after complex treatment of breast cancer

Bosieva,

Zikiryakhodzhaev,

Usov

et al. 2024

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Breast reconstruction with a thoracodorsal flap (TDF) in combination with a tissue expander/implant is a wellestablished technique.The purpose of the study was to present current data on the results of delayed breast reconstruction with thoracodorsal flap and tissue expander after combined/complex treatment in patients with breast cancer.Material and methods. The search for relevant sources was carried out in the PubMed, Cochrane Library, E-library systems, publications from 2014 to 2022 were studied. Delayed breast reconstruction using TDF in combination with a tissue expander/implant is a reliable method of reconstruction for the group of patients who have previously undergone radical mastectomy or adjuvant external beam radiation therapy in terms of combined/complex treatment of breast cancer, allowing to achieve good and excellent aesthetic results with a low incidence of surgical complications.Results and discussion. The use of the latissimus dorsi flap is a reliable and universal method of breast reconstruction, it allows achieving good and excellent aesthetic results, high patient satisfaction. Patients with a low body mass index or obesity, a history of abdominal surgery, including abdominoplasty, are not candidates for reconstruction using anterior abdominal wall flaps, and therefore the only possible method of breast reconstruction for them is the method using the TDF. In addition, the use of the TDF may be most appropriate for women who are planning a pregnancy in the future and for whom the use of anterior abdominal wall flaps will not be an optimal method of reconstruction due to reduced abdominal wall compliance. Other reasons why the use of TDF is the method of choice for many surgeons are the possibility of closing the donor site regardless of the size of the skin flap taken, the possibility of closing such defects of the mammary gland as extrusions, protrusions, in case of insufficiency of the skin cover after skin-preserving mastectomies.Conclusion. The use of the latissimus dorsi flap is a reliable and universal method of breast reconstruction, it allows achieving good and excellent aesthetic results, a high degree of patient satisfaction.

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Delayed breast reconstruction with transverse latissimus dorsi myocutaneous flap using Becker expander implants in patients submitted to radiotherapy: A series of cases

Cited by 2 publications

References 28 publications

Volumetric changes of the latissimus dorsi muscle after postoperative chemotherapy in cases of immediate breast reconstruction with an extended latissimus dorsi musculocutaneous flap and implant

Volumetric changes of the latissimus dorsi muscle after postoperative chemotherapy in cases of immediate breast reconstruction with an extended latissimus dorsi musculocutaneous flap and implant

Delayed breast reconstruction with the thoracodorsal flap and endoprosthesis after complex treatment of breast cancer

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