Lateral thoracoaxillar dermal-fat flap for breast conserving surgery: the changes of the indication and long-term results View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-03-07

AUTHORS

Hiroshi Nakagomi, Masayuki Inoue, Haruka Nakada, Masato Ohmori, Yuko Nakayama, Kazushige Furuya, Hideki Watanabe, Kou Ikegame, Koichi Kobayashi

ABSTRACT

BackgroundOncoplastic breast conserving surgery had been challenged to achieve both of local control and the cosmetic appearance of preserved breast. We developed the lateral thoracoaxillar dermal-fat flap (LTDF) as an oncoplastic procedure to fill the defect of breast-conserving surgery in 1999.MethodsA total of 2338 breast cancer patients underwent surgery from January, 2000 to December, 2017. Mastectomy was performed in 706 patients (30%), and breast conservative surgery (BCS) was performed in 1634 patients (70%). The LTDF was adopted in 487/1634 (30%) of BCS cases to fill the large defect left by partial resection. we divided all patients into 3 groups: breast total mastectomy (BT group), the breast partial resection (BP) with LTDF (LTDF group), and Bp without LTDF (BP group) and compared the clinical characteristics, and recurrence rate.ResultsThe Indications for LTDF increased up to 40% in 2010, while they decreased to 20%–30% in the most recent period, in accordance with the frequency of breast reconstruction increased. Patients who underwent BP + LTDF (LTDF group) included significantly higher proportions of stage II diseases and cases treated by neoadjuvant chemotherapy than those in BP or BT groups.. We found no marked difference of local recurrence and distant metastases between the LTDF and Bp groups. However, the rate of distant metastasis was significantly higher in BT group than in the Bp or LTDF group. Concerning the complications of LTDF, we experienced a few complications of Grade 3–4 requiring surgical management, namely one case of dislocation of the LTDF, three cases of bleeding, and five cases each of skin necrosis and fat necrosis.ConclusionsWe reported satisfying long-term outcomes of 487 cases treated by LTDF. LTDF is a suitable oncoplastic technique for BCS. More... »

PAGES

595-601

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s12282-019-00959-2

DOI

http://dx.doi.org/10.1007/s12282-019-00959-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1112607066

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30847663


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35 schema:description BackgroundOncoplastic breast conserving surgery had been challenged to achieve both of local control and the cosmetic appearance of preserved breast. We developed the lateral thoracoaxillar dermal-fat flap (LTDF) as an oncoplastic procedure to fill the defect of breast-conserving surgery in 1999.MethodsA total of 2338 breast cancer patients underwent surgery from January, 2000 to December, 2017. Mastectomy was performed in 706 patients (30%), and breast conservative surgery (BCS) was performed in 1634 patients (70%). The LTDF was adopted in 487/1634 (30%) of BCS cases to fill the large defect left by partial resection. we divided all patients into 3 groups: breast total mastectomy (BT group), the breast partial resection (BP) with LTDF (LTDF group), and Bp without LTDF (BP group) and compared the clinical characteristics, and recurrence rate.ResultsThe Indications for LTDF increased up to 40% in 2010, while they decreased to 20%–30% in the most recent period, in accordance with the frequency of breast reconstruction increased. Patients who underwent BP + LTDF (LTDF group) included significantly higher proportions of stage II diseases and cases treated by neoadjuvant chemotherapy than those in BP or BT groups.. We found no marked difference of local recurrence and distant metastases between the LTDF and Bp groups. However, the rate of distant metastasis was significantly higher in BT group than in the Bp or LTDF group. Concerning the complications of LTDF, we experienced a few complications of Grade 3–4 requiring surgical management, namely one case of dislocation of the LTDF, three cases of bleeding, and five cases each of skin necrosis and fat necrosis.ConclusionsWe reported satisfying long-term outcomes of 487 cases treated by LTDF. LTDF is a suitable oncoplastic technique for BCS.
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54 breast reconstruction
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57 cases
58 cases of dislocation
59 changes
60 characteristics
61 chemotherapy
62 clinical characteristics
63 complications
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67 cosmetic appearance
68 defects
69 dermal fat flap
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86 management
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91 neoadjuvant chemotherapy
92 oncoplastic procedures
93 oncoplastic techniques
94 outcomes
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96 patients
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99 proportion
100 rate
101 recent period
102 reconstruction
103 recurrence
104 recurrence rate
105 resection
106 results
107 skin necrosis
108 stage II disease
109 surgery
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