Oncoplastic breast-conserving surgery: analysis of quadrantectomy and immediate reconstruction with latissimus dorsi flap.
BACKGROUND
Oncoplastic breast-conserving surgery satisfies oncologic principles and improves cosmetic outcomes, even when an important breast volume excision is required.


METHODS
We reviewed 28 patients suffering from breast cancer treated with quadrantectomy and immediate myocutaneous latissimus dorsi flap reconstruction. We evaluated the status of the surgical margins, early complications, and cosmetic outcome. Cosmetic assessment was carried out by a panel made up of three women and one man: a female member of an association against breast cancer, a female general practitioner, a female gynecologic resident, and a male breast-specialized surgeon.


RESULTS
Free margins were obtained in all cases. There were 11 postoperative complications: 9 seromas at the donor site, 1 dehiscence of the back wound, and 1 minor partial flap skin necrosis. Chemotherapy and radiotherapy adjuvant treatment was not compromised. The cosmesis outcome was deemed to be good in 43.75% of the cases and satisfactory in 56.25%. The score for overall cosmesis outcome was 6.92 out of 10. Symmetry and the scar of the reconstructed breast were the most influential criteria in the quantitative assessment of overall cosmetic results.


CONCLUSIONS
Partial mastectomy (quadrantectomy) and immediate reconstruction with a myocutaneous latissimus dorsi flap allows extensive resection, which fits oncologic requirements, without serious morbidity and a good cosmetic outcome.
Hospital Universitario Valdecilla, Breast Unit, University of Cantabria, Avda Valdecilla sn, 39008, Santander, Cantabria, Spain. cgdhff@humv.es
Fernando
F
Hernanz
Sara
S
Regaño
Carlos
C
Redondo-Figuero
Victoria
V
Orallo
Fernando
F
Erasun
Manuel
M
Gómez-Fleitas
D000328:Adult; D001943:Breast Neoplasms / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000601:surgery*; D018275:Carcinoma, Lobular / Q000601:surgery; D000075202:Contraindications; D004954:Esthetics; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental / Q000379:methods; D008875:Middle Aged; D018579:Patient Selection; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps