title: The use of latissimus dorsi miniflap for reconstruction following breast-conserving surgery: experience of a small breast unit in a district hospital.
abstract: BACKGROUND
  Immediate reconstruction with autogenous tissue is one of the options for reconstruction following breast-conservation surgery for breast cancers in major centres with ready availability of appropriate skills. Immediate correction of volume deficit by latissimus dorsi miniflap (LDMF) in addition has cosmetic appeal by filling the defect without extra skin incision.
  
  
  METHODS
  Data was collected retrospectively from clinical records of 51 patients who underwent LDMF procedures in a district general hospital between June 2000 and December 2004, and the results were analysed. Postal questionnaire survey was done to assess the level of subjective satisfaction of the cosmetic outcome.
  
  
  RESULTS
  Wide local excision and axillary-node sampling/clearance along with immediate reconstruction with a LDMF (involving a musculo-subcutaneous flap without skin) were performed in all patients. Patients' median age was 50 years. Sixty-five percent of the tumours were in the upper-outer quadrant, median weight of the specimen was 217.5 g (31-510 g), median clearance margin was 5 mm (0-15 mm) and median pathological size of the tumour was 20 mm (8-60 mm). Four patients required mastectomy later, whereas 1 patient had flap necrosis. At a median follow-up of 33 months, there has been no recurrence. Eighty-six percent of the patients who responded to the postal survey were satisfied with the cosmetic outcome.
  
  
  CONCLUSIONS
  Immediate LDMF reconstruction is an acceptable way of correcting deformity after breast-conservation surgery. We demonstrate by our experience that it is a viable option for breast cancer in small district hospitals/ breast units.
authors.affiliation: Department of Surgery, Bassetlaw Hospital, Worksop, Nottinghamshire, UK.
authors.forename: C
authors.initials: C
authors.lastname: Navin
authors.forename: A
authors.initials: A
authors.lastname: Agrawal
authors.forename: K M
authors.initials: KM
authors.lastname: Kolar
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000601:surgery*; D005260:Female; D006767:Hospitals, District; D006801:Humans; D016462:Mammaplasty / Q000191:economics / Q000379:methods*; D015412:Mastectomy, Segmental; D008875:Middle Aged; D017060:Patient Satisfaction; D013524:Surgical Flaps