Partial breast reconstruction for an inferomedial breast carcinoma using an omental flap.
BACKGROUND
Various oncoplastic techniques are used for partial reconstruction after breast-conserving surgery (BCS), but treatment of an inferomedial breast carcinoma (IMBC) can be difficult, especially in a small breast. We review our experience with immediate partial breast reconstruction after BCS for an IMBC using a laparoscopically harvested omental flap (OF).


METHODS
The subjects were 24 patients with an IMBC who underwent immediate partial breast reconstruction with the OF between April 2002 and June 2009. A wide excision (>20% of the breast tissue) was performed through a skin incision along the medial inframammary fold. The pedicled OF was harvested laparoscopically and used to fill the dead space in the inferomedial quadrant.


RESULTS
The mean follow-up period was 35 months. The mean tumor size was 3.2 cm. The mean volume of resected breast tissue was 180 g and the mean extent of resection was 40%. The complication rate was 12.5% and all were minor and treated conservatively. Laparoscopy-associated complications did not occur, except for one minor injury of the gastroepiploic artery. The surgical margin was positive in only 1 patient (4.2%) and neither local nor systemic recurrence has occurred to date in any patients. Cosmetic outcomes were mostly satisfactory, with minimal donor-site scars in the abdominal wall. Cosmetic failure occurred in 1 patient (4.2%) due to an inadequate OF volume.


CONCLUSIONS
Laparoscopic harvesting of the OF is a safe procedure with minimal donor-site morbidities and deformities. This approach is an option for immediate partial reconstruction after BCS for an IMBC.
Zaha
Hisamitsu
H
Department of Surgery, Nakagami Hospital, 6-25-5 Chibana, Okinawa-City, Okinawa, 904-2195, Japan. hisamitu@nakagami.or.jp
Sunagawa
Hiroki
H
Kawakami
Kouji
K
Touyama
Tetsuo
T
Yonaha
Toshimi
T
Ohshiro
Naoto
N
D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D004954:Esthetics; D005260:Female; D006801:Humans; D010535:Laparoscopy; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D009852:Omentum / Q000637:transplantation*; D011183:Postoperative Complications; D013524:Surgical Flaps; D016896:Treatment Outcome