Immediate Breast and Chest Wall Reconstruction for Advanced Breast Cancer.

Yang, Jung Dug; Kim, Hak Tae; Chung, Ho Yun; Cho, Byung Chae; Choi, Kang Young; Lee, Jung Hun; Lee, Jeong Woo; Park, Ho Yong; Jung, Jin Hyang; Chae, Yee Soo

Search: J Korean Soc Plast Reconstr Surg Search

CLOSE

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2011;38(5):627-635.
Published online September 1, 2011.

Immediate Breast and Chest Wall Reconstruction for Advanced Breast Cancer.

Jung Dug Yang, Hak Tae Kim, Ho Yun Chung, Byung Chae Cho, Kang Young Choi, Jung Hun Lee, Jeong Woo Lee, Ho Yong Park, Jin Hyang Jung, Yee Soo Chae

¹Department of Plastic and Reconstructive Surgery, Graduated School of Medicine, Kyungpook National University, Daegu, Korea. lambyang@paran.com
²Department of Surgery, Graduated School of Medicine, Kyungpook National University, Daegu, Korea.
³Department of Internal Medicine, Graduated School of Medicine, Kyungpook National University, Daegu, Korea.

Abstract

PURPOSE
Advanced breast cancer traditionally has been perceived as a contraindication to immediate breast reconstruction, because of concerns regarding adjuvant treatment delays and the cosmetic effects of radiotherapy to breast reconstruction, so delayed reconstruction is usually preferred in advanced breast cancer patients undergoing mastectomy. However, with the improved outcome using multimodality therapy, consisting of perioperative chemotherapy and radiotherapy, immediate breast reconstruction is now being performed as surgical option for selected advanced breast cancer patients. Additionally, advanced breast cancer patients may be needed soft tissue coverage of an extensive skin and soft tussue defect after mastectomy. Current authors have experienced several types of immediate breast and chest wall reconstruction for advanced breast cancer. METHODS: From December of 2007 to June of 2009, 14 women performed for immediate breast and chest wall reconstruction for advanced breast cancer. They had been treated with neoadjuvant chemotherapy or chemoradiotherapy followed by modified radical mastectomy or radical mastectomy. Four different techniques were used immediate breast and chest wall reconstruction, which are pedicled TRAM flap(4 cases), extended LD flap with STSG(3 cases), thoracoabdominal flap(4 cases) and thoracoepigastric flap(3 cases).
RESULTS
The mean age was 53 years and mean follow up period was 9 months. Patients' oncologic status ranged stage IIIa to stage IV. Two patients had major complications: partial flap necrosis of TRAM flap and one distal necrosis of thoracoabdominal flap. Three patients with stage IV disease died from metastases.
CONCLUSION
The result of this study suggests that immediate breast and chest wall reconstruction can be considered as surgical option for advanced breast cancer. But we need long term follow up and large prospective studies for recurrence and survival.

Keywords: Advanced breast cancer; Immediate breast and chest wall reconstruction

TOOLS