Dermoglandular rotation flap with subaxillary advancement flap as an oncoplastic technique for breast cancer

Lee, Seok-Won; Jung, Young‐Sik; Bae, Yong Chan

doi:10.1111/tbj.13503

Cited by 5 publications

(5 citation statements)

References 24 publications

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“…However, in accordance with the hypothesis of a lower volume of resection in the RB group, as an intrinsic limit of the procedure in our hands, all cases of re-excision for positive margins occurred in these patients, and always for a DCIS diagnosis [ 14 ]. In this context, several authors assessed that subaxillary dermocutaneous fat flaps can be used in all patients, regardless of breast size, if no more than 25 per cent of the breast tissue is removed for tumour clearance [ 26 ].…”

Section: Discussionsupporting

confidence: 87%

“…All patients with superolateral tumors are potential candidates for subaxillary flap reconstruction, although some limitations to this procedure exist in thin patients, with insufficient tissue to replace the volume removed and reduce the deformity to an acceptable level. In this regard, it is important to allow optimal positioning of the axillary incisions to avoid scar widening or an ischemic flap with subsequent necrosis [ 14 ]. Moreover, an important requirement for applying a correct approach should consider that the primary tension of the closure never have to displace a neighboring structure and the prominent landmarks, especially the nipple and the inframammary fold.…”

Section: Surgical Techiniquementioning

confidence: 99%

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Subaxillary Replacement Flap Compared with the Round Block Displacement Technique in Oncoplastic Breast Conserving Surgery: Functional Outcomes of a Feasible One Stage Reconstruction

et al. 2022

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Background: For selected women diagnosed with breast cancer (BC), partial reconstructive techniques involve displacement or replacement procedures to improve cosmesis without compromising oncological safety. This study aims to evaluate the surgical outcomes of the round block (RB) compared with the subaxillary flap (SF) technique for patients with upper outer tumor. Patients and Methods: Thirty-three patients treated with oncoplastic conserving surgery (15 RB and 18 SF) were enrolled in this retrospective study. After carrying out a comparison of baseline characteristics, all cases were recruited for postoperative evaluation of oncological and cosmetic parameters. Moreover, we investigated several scoring combinations to check whether they could discriminate surgeon and patient satisfaction according to different functional results. Results: Median age (p < 0.05), average tumor size (p > 0.05), estimated resection volume (p > 0.05), and nodal involvement (p > 0.05) were slightly higher in the SF group. A greater frequency of DCIS (p < 0.05) in the RB series correlated with reintervention for positive margins (p > 0.001). At a mean follow-up of 19 months, no locoregional recurrences were recorded and early and late complications were comparable (p > 0.05). The overall satisfaction with cosmesis was characterized by similar proportions of good results (p > 0.05), with some details more related to each procedure. Conclusion: The proposed techniques represent effective solutions for reshaping that follows upper outer wide excision, achieving comparable complication rates, low reinterventions, and good aesthetic results in relation to technical and social functioning evaluations. However, it is crucial to establish a careful patient selection in order to manage correct surgical planning while predicting any potential sequelae or complication.

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Section: Discussionsupporting

confidence: 87%

Section: Surgical Techiniquementioning

confidence: 99%

Subaxillary Replacement Flap Compared with the Round Block Displacement Technique in Oncoplastic Breast Conserving Surgery: Functional Outcomes of a Feasible One Stage Reconstruction

et al. 2022

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“…Currently, the relay skin flap transfer approach has no precise definition. It is generally agreed that this kind of flap transfer is used to repair a primary wound with the flap of 1 donor site and a secondary wound with the flap of the other donor site, using the tension difference of the 2 adjacent donor sites (7,8). This approach can lead to the direct suture of donor sites and avoids other disadvantages, such as grafting on wounds and donor site enlargement (9).…”

Section: Discussionmentioning

confidence: 99%

The clinical application of lateral chest flap transfer combined with relay skin flap transfer to repair soft tissue defects of the chest wall after tumor resection

Guo¹,

Wang²,

Wang³

et al. 2022

J Thorac Dis

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Background: After thoracic tumor resection, there is often a large area of soft tissue defect left, even with exposed ribs and sternum, which needs to be repaired by skin flap transplantation. This study aims to introduce lateral thoracic flaps combined with local flaps to repair the soft tissue defect of the chest wall after the repair of malignant tumors, and try to retain the latissimus dorsi myocutaneous flap as a spare repair myocutaneous flap to avoid subsequent tumor recurrence and lack of local flaps for supply body source.Methods: A total of 26 patients with chest wall soft tissue defect with or without exposed rib and sternum after tumor resection at presentation from January 2017 to October 2021 were included in this study. None of the patients required breast reconstruction. Patients ranged in age from 34 to 56 years old. The above patients were treated with lateral thoracic flaps combined with local rotational advancement flaps to repair chest wall soft tissue defects. The postoperative wound healing, scar hyperplasia and recurrence of the patients were followed up.Results: Among the patients in this study, 25 incisions healed by primary incision, 1 incision was delayed, and healed after 10 days of dressing change. Postoperatively, the incisions of the patients were all intact, and there were no complications such as skin necrosis and infection. All patients were followed up for 6-18 months, and the incision healed well without complications such as skin necrosis and infection. Of the patients, 2 males developed dermatofibrosarcoma carina recurrence 6 and 10 months after surgery, respectively. After extensive excision, an ipsilateral latissimus dorsi myocutaneous flap was used to repair the defect. The Vancouver scar scale was used to evaluate the hyperplasia of all incisions at 6 months postoperatively. The mean score was 5.92±1.6. Conclusions:The lateral thoracic flap combined with the local flap to repair the chest wall soft tissue defect after tumor surgery is a strategic decision for surgical treatment, which is beneficial to the sequential surgical treatment of tumor patients.

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“…One possible option for oncoplastic resection in cases with localization of tumor in upper-inner quadrant of the breast is dermoglandular triangular rotation flap (24)(25)(26).…”

Section: Operation Optionsmentioning

confidence: 99%

Planning and use of oncoplastic surgery for breast cancer

Samusieva

Любота

Zaichuk

et al. 2023

RHW

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Today, breast conserving surgery among women with different stages of breast cancer is increasing. In addition, these operations do not differ in oncological radicality and do not show differences in relation to survival compared to mastectomy, but their cosmetic and psychological benefits are significant. In search of a balance between the risk of local recurrence and cosmetic results in surgical interventions in breast cancer, new surgical variants were introduced – a combination of breast conserving surgery with plastic surgery, so-called oncoplastic surgery. Oncoplastic surgery has been widely developed in the surgical treatment of breast cancer in the last decade. In oncoplastic breast surgery, the tumors of the upper-inner quadrant of the breast are problematic and require more attention of the surgeon. In these cases the size and location of the tumor are two important factors for the post-operative cosmetic outcome. In this article we introduce a modified dermoglandular rotation flap technique, which can be applied for relatively large tumors of inner quadrant of the breast without surgery of the contralateral breast for symmetrical effect. With this technique, a larger breast tumor could be removed without compromising the breast appearance. An important aspect of breast conserving surgery is preoperative evaluation of the clinical and biological features of the tumor as well as the morphological aspects of tumor allow the surgeon to make a decision if a conservative is possible and select the most effective oncoplastic surgical technique. Oncoplastic techniques may improve cosmetic view and patient satisfaction without compromising the oncological outcomes, which is confirms the clinical utility of this approach to the surgical management of patients with breast cancer. The article also presents clinical cases – 46 years old patient with left breast cancer (stage I cT1N0M0 pT1N0M0) and a patient of 42 years old with right breast cancer (stage I cT1NXM0 pT1N0M0) in the treatment of which the described technique was applied.

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Dermoglandular rotation flap with subaxillary advancement flap as an oncoplastic technique for breast cancer

Cited by 5 publications

References 24 publications

Subaxillary Replacement Flap Compared with the Round Block Displacement Technique in Oncoplastic Breast Conserving Surgery: Functional Outcomes of a Feasible One Stage Reconstruction

Subaxillary Replacement Flap Compared with the Round Block Displacement Technique in Oncoplastic Breast Conserving Surgery: Functional Outcomes of a Feasible One Stage Reconstruction

The clinical application of lateral chest flap transfer combined with relay skin flap transfer to repair soft tissue defects of the chest wall after tumor resection

Planning and use of oncoplastic surgery for breast cancer

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