Title
Defining the Role of Free Flaps in Partial Breast Reconstruction
Publication Date
2018
Journal Title
J Reconstr Microsurg
Abstract
Copyright © 2018 by Thieme MedicalPublishers. Background Free flaps have a well-established role in breast reconstruction after mastectomy; however, their role in partial breast reconstruction remains poorly defined. We reviewed our experience with partial breast reconstruction to better understand indications for free tissue transfer. Methods A retrospective review was performed of all patients undergoing partial breast reconstruction at our center between February 2009 and October 2015. We evaluated the characteristics of patients who underwent volume displacement procedures versus volume replacement procedures and free versus pedicled flap reconstruction. Results There were 78 partial breast reconstructions, with 52 reductions/tissue rearrangements (displacement group) and 26 flaps (replacement group). Bra cup size and body mass index (BMI) were significantly smaller in the replacement group. Fifteen pedicled and 11 free flaps were performed. Most pedicled flaps (80.0%) were used for lateral or upper pole defects. Most free flaps (72.7%) were used for medial and inferior defects or when there was inadequate donor tissue for a pedicled flap. Complications included hematoma, cellulitis, and one aborted pedicled flap. Conclusion Free and pedicled flaps are useful for partial breast reconstruction, particularly in breast cancer patients with small breasts undergoing breast-conserving treatment (BCT). Flap selection depends on defect size, location, and donor tissue availability. Medial defects are difficult to reconstruct using pedicled flaps due to arc of rotation and intervening breast tissue. Free tissue transfer can overcome these obstacles. Confirming negative margins before flap reconstruction ensures harvest of adequate volume and avoids later re-operation. Judicious use of free flaps for oncoplastic reconstruction expands the possibility for breast conservation.
Volume Number
34
Issue Number
3
Pages
185 - 192
Document Type
Article
Status
Faculty
Facility
School of Medicine
Primary Department
Surgery
PMID
DOI
10.1055/s-0037-1607363
This document is currently not available here.
COinS
Comments
Hofstra Northwell School of Medicine and Northwell Health currently do not subscribe to this title. If you are an affiliate and would like to access the full text please request it via interlibrary loan via Hofstra Northwell School of Medicine ILL (faculty and students only) or Northwell Health ILL