title: Cosmetic evaluation following volume replacement using lateral tissue flap in breast-conserving surgery.
abstract: BACKGROUND
  We examined the effectiveness of volume replacement using a lateral tissue flap (LTF) in breast-conserving surgery for a good cosmetic outcome.
  
  
  METHODS
  We analyzed the results of 130 patients with breast cancer who underwent breast-conserving surgery with replacement using an LTF from 2006 to 2010 with cosmetic evaluations performed according to the criteria of the Japanese Breast Cancer Society. We examined scores with regard to the following possible contributing factors: partial resection (Bp) or quadrantectomy (Bq), diameter of the specimen, body mass index (BMI), axillary lymphadenectomy, postoperative irradiation, and position of the tumor.
  
  
  RESULTS
  The scores for cases with Bp and non-postoperative irradiation were higher than those for Bq and postoperative irradiation cases, though they were not significant factors in multivariate analysis. A negative correlation was seen between score and diameter of the specimen, whereas there was no significant correlation with BMI. There was no significant difference between scores of cases with or without an axillary lymphadenectomy. However, the score for the extended upper-outer area including the upper and outer borders was significantly higher than scores for other portions. In multiple regression analysis, cases with a tumor diameter less than 4 cm in the extended upper-outer area or less than 2 cm in other areas showed good adaptation.
  
  
  CONCLUSIONS
  Tumor location and diameter are important factors for cosmetic evaluation of volume replacement using an LTF.
authors.affiliation: Department of Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kitaku, Sakai, Osaka, 591-8025, Japan, morisima@bd5.so-net.ne.jp.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Morishima
authors.forename: Nobuki
authors.initials: N
authors.lastname: Matsunami
authors.forename: Junichi
authors.initials: J
authors.lastname: Hasegawa
authors.forename: Shoki
authors.initials: S
authors.lastname: Mikata
authors.forename: Junzo
authors.initials: J
authors.lastname: Shimizu
authors.forename: Yokoku
authors.initials: Y
authors.lastname: Kim
authors.forename: Masaki
authors.initials: M
authors.lastname: Hirota
authors.forename: Yukako
authors.initials: Y
authors.lastname: Mokutani
authors.forename: Mariko
authors.initials: M
authors.lastname: Araki
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Miyake
authors.forename: Riichiro
authors.initials: R
authors.lastname: Nezu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D015999:Multivariate Analysis; D013518:Surgery, Plastic / Q000379:methods; D013524:Surgical Flaps