[Chest wall reconstruction for recurrent breast cancer].
Some recurrences of breast cancer require wide chest wall resection as curative or palliative therapy. We report a retrospective review of 14 chest wall resections and reconstructions. The width of the anterior chest wall excision was 150 cm(2) (80 to 360 cm(2)). Two defects were full-thickness ones, with sternal or costal resection. The reconstruction required synthetic mesh covered by a latissimus dorsi musculocutaneous flap. The 12 other resections were superficial ones, and have been covered by a skin graft in 5 patients, and by a regional flap in 7 patients (5 latissimus dorsi, 1 DIEP, and 1 bilobed flap). Two patients had a chest wall irradiation after the surgical procedure. We have analysed the factors, which had influenced our choice of the type of reconstruction. The reconstruction is performed by a regional flap, most commonly a latissimus dorsi pedicled flap, in case of full-thickness defect, of nodular isolated recurrence, or when a radiation therapy is provided after the surgical procedure. The coverage is made by a skin graft in case of palliative excision, or of multiple nodular chest wall recurrence (which have a high risk of recurrence in the same form).
Choisy-Klifa
M
M
Service de chirurgie plastique, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France. marieklifa@yahoo.fr
Binder
J-P
JP
Revol
M
M
Servant
J-M
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016038:Skin Transplantation; D013524:Surgical Flaps; D013526:Surgical Mesh; D035441:Thoracic Wall / Q000601:surgery*