title: Breast reconstruction in low resource settings: Autologous latissimus dorsi flap provides a viable option.
abstract: BACKGROUND
  Breast reconstruction (BR) plays a significant role in the woman's physical, emotional and psychological recovery from breast cancer. However, the current most accepted methods of reconstruction are expensive, may require microsurgical skills and can be offered to a very small number of patients seeking treatment in tertiary care centers. For the large majority of women seeking treatment in public hospitals, solution lies in finding a method of reconstruction, which is autologous, produces a reasonable match to the contralateral breast in size, shape and symmetry and produces minimal donor site morbidity. It should also be a technique, which is cost effective and can withstand the effects of radiotherapy (RT). The autologous latissimus dorsi (LD) flap is one such versatile technique, which can serve as an ideal reconstructive option for the majority of patients.
  
  
  METHODS
  During a period of 6 years, 19 patients underwent immediate BR using this flap in the Department of General Surgery. Patients who were young (mean age 37.4 years), had small to medium sized breasts, with operable breast cancer (Stage II and IIIa) were selected for the procedure.
  
  
  RESULTS
  Satisfactory cosmetic results as rated by patients as well as surgeons were achieved in the majority. Donor site morbidities were seroma formation (78%) and donor site wound breakdown (21%). Post-operative RT was well-tolerated by the reconstructed breast.
  
  
  CONCLUSIONS
  Autologous LD flap reconstruction is a safe and economical option for BR in low resource settings and is suitable for women with small and medium sized breasts.
authors.affiliation: Department of Surgery, University College of Medical Sciences and GTB Hospital, University of Delhi, Delhi, India.
authors.forename: N
authors.initials: N
authors.lastname: Kaur
authors.forename: A
authors.initials: A
authors.lastname: Gupta
authors.forename: S
authors.initials: S
authors.lastname: Saini
mesh_terms: D000328:Adult; D001940:Breast / Q000473:pathology / Q000601:surgery; D001943:Breast Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000145:classification / Q000473:pathology; D064171:Superficial Back Muscles / Q000473:pathology / Q000601:surgery*; D013524:Surgical Flaps; D014182:Transplantation, Autologous / Q000379:methods*