title: Oncoplastic volume replacement techniques according to the excised volume and tumor location in small- to moderate-sized breasts.
abstract: BACKGROUND
  In the treatment of cancer patients with small breasts, breast-conserving surgery (BCS) with adjuvant radiotherapy has become popular. In Korean women, many of whom have small- to moderate-sized breasts, the removal of an adequate volume of tissue during breast cancer surgery may compromise the cosmetic outcome and sometimes cause unpleasant results. In such cases, oncoplastic volume replacement techniques can be valuable.
  
  
  METHODS
  Between January 2007 and December 2013, 213 women underwent 216 BCSs with various oncoplastic volume replacement techniques selected according to the volume of breast tissue excised. When the excised volume was <150 g, regional flaps such as a lateral thoracodorsal or thoracoepigastric flap, or perforator flaps such as an intercostal artery perforator (ICAP) flap or a thoracodorsal artery perforator (TDAP) flap were used. When the excised volume was >150 g, a latissimus dorsi (LD) myocutaneous flap was used.
  
  
  RESULTS
  The mean age was 45.7 years, and the mean follow-up interval was 11.3 months. The mean excised volume was 148.4 g. The oncoplastic volume replacement techniques used included 22 lateral thoracodorsal flaps, 8 thoracoepigastric flaps, 29 ICAP flaps, 20 TDAP flaps, and 137 LD myocutaneous flaps. Postsurgical complications occurred in 30 cases, including 1 case of congestion and 26 cases of seroma in LD myocutaneous flaps, and 3 cases of fat necrosis in ICAP flaps. Most of the patients were satisfied with the cosmetic outcome.
  
  
  CONCLUSIONS
  Oncoplastic volume replacement techniques according to the excised volume and tumor location are reliable and useful for the correction of breast deformity after BCS, especially in patients with small- to moderate-sized breasts.
authors.affiliation: 1 Department of Plastic and Reconstructive Surgery, 2 Department of Surgery, Graduate School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
authors.forename: Jeong Woo
authors.initials: JW
authors.lastname: Lee
authors.affiliation: 1 Department of Plastic and Reconstructive Surgery, 2 Department of Surgery, Graduate School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
authors.forename: Min Chul
authors.initials: MC
authors.lastname: Kim
authors.affiliation: 1 Department of Plastic and Reconstructive Surgery, 2 Department of Surgery, Graduate School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
authors.forename: Ho Yong
authors.initials: HY
authors.lastname: Park
authors.affiliation: 1 Department of Plastic and Reconstructive Surgery, 2 Department of Surgery, Graduate School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
authors.forename: Jung Dug
authors.initials: JD
authors.lastname: Yang
keywords: Breast neoplasms; breast reconstruction; mammaplasty; surgical flaps
references.citation: Ann Surg Oncol. 2005 Jul;12(7):539-45
references.pmid: 15889210
references.citation: Ann Surg. 2003 Jan;237(1):26-34
references.pmid: 12496527
references.citation: Arch Plast Surg. 2013 Jul;40(4):367-73
references.pmid: 23898433
references.citation: Br J Plast Surg. 1977 Oct;30(4):277-81
references.pmid: 338072
references.citation: JAMA. 1991 Jan 16;265(3):391-5
references.pmid: 1984541
references.citation: Ann Plast Surg. 2011 Nov;67(5):474-80
references.pmid: 21301298
references.citation: N Engl J Med. 1981 Jul 2;305(1):6-11
references.pmid: 7015141
references.citation: Lancet Oncol. 2005 Mar;6(3):145-57
references.pmid: 15737831
references.citation: Plast Reconstr Surg. 1986 Jun;77(6):933-43
references.pmid: 3714889
references.citation: J Plast Reconstr Aesthet Surg. 2006;59(6):644-52
references.pmid: 16716957
references.citation: Br J Plast Surg. 2004 Sep;57(6):531-9
references.pmid: 15308400
references.citation: Breast. 2011 Jun;20(3):233-40
references.pmid: 21292485
references.citation: Plast Reconstr Surg. 2007 Jul;120(1):1e-5e
references.pmid: 17572537
references.citation: N Engl J Med. 1985 Mar 14;312(11):665-73
references.pmid: 3883167