Immediate Partial Breast Reconstruction with Latissimus Dorsi Flap
DOI:
https://doi.org/10.64295/cujahr.v9i09.51Keywords:
Breast Cancer, Wide Local Excision, Breast Reconstruction, Latissimus Dorsi FlapAbstract
Background: Immediate breast reconstruction (IBR) is known to improve psychosocial well-being without compromising oncological safety. The latissimus dorsi flap (LDF) is a versatile and established technique for IBR. This study aimed to evaluate the outcomes of the LDF for immediate partial breast reconstruction, focusing on complications, recurrence, and patient satisfaction.
Methods: This prospective study, conducted from June 2021 to June 2024, included patients with early-stage breast cancer undergoing immediate partial LDF reconstruction following wide local excision and axillary dissection. Data on patient demographics, tumor pathology, surgical procedures, and outcomes—including complications, recurrence, and satisfaction—were analyzed.
Results: Ten patients were included (mean age: 33.8±8.08 years; mean BMI: 24.24±4.49 kg/m²). Most tumors (60%) were located in the upper outer quadrant, and 90% were histologically identified as invasive ductal carcinoma. Neoadjuvant chemotherapy was administered to 70% of patients. The reconstructive techniques included myocutaneous LDF (50%), latissimus dorsi muscle flap (20%), and mini-LDF (30%). The primary complication was donor-site seroma (20%). One patient, who declined adjuvant therapy, experienced recurrence. Patient satisfaction with the overall outcome was 100%.
Conclusion: Immediate partial breast reconstruction using the latissimus dorsi flap is a safe and reliable technique that provides excellent oncological and cosmetic outcomes.
References
Torre LA, Islami F, Siegel RL, Ward EM, Jemal A. Global Cancer in Women: Burden and Trends. Cancer Epidemiol Biomarkers Prev. 2017;26(4):444–57.
Rainsbury RM, Paramanathan N. UK survey of partial mastectomy and reconstruction. Breast. 2007;16(6):637-45.
Veronesi U, Cascinelli N, Mariani L, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347(16):1227–32.
Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347(16):1233–41.
Oiz B. Breast Reconstruction and Psychological Benefit. An Sist Sanit Navar. 2005;28(Suppl. 2):19-26.
Huston TL, Simmons RM. Locally recurrent breast cancer after conservation therapy. Am J Surg. 2005;189(2):229–35.
Lee J, Jung JH, Kim WW, et al. Five-year oncologic outcomes of volume displacement procedures after partial mastectomy for breast cancer. Clin Breast Cancer. 2017;17(1):70–5.
Audretsch WP, et al. Reconstruction of the partial mastectomy defect: classification and method. In: Spear SL, Willey SC, Robb GL, et al., editors. Surgery of the breast: principles and art. Philadelphia: Lippincott Williams and Wilkins; 2006. p. 179–216.
Troidl H, Kusche J, Vestweber K, Eypasch E, Koeppen L, Bouillon B. Quality of Life: An Important Endpoint Both in Surgical Practice and Research. J Chron Dis. 1987;40(6):523-8.
Revicki D. FDA Draft Guidance and Health-Outcomes Research. Lancet. 2007;369(9561):540-2.
Pusic AL, Chen CM, Cano S, Klassen A, McCarthy C, Collins ED, et al. Measuring Quality of Life in Cosmetic and Reconstructive Breast Surgery: A Systematic Review of Patient-Reported Outcome Instruments. Plast Reconstr Surg. 2007;120(4):823-37.
Schain WS, Wellisch DK, Pasnau RO, Landsverk J. The sooner the better: a study of psychological factors in women undergoing immediate versus delayed breast reconstruction. Am J Psychiatry. 1985;142(1):40-6.
Khoo A, Kroll SS, Reece GP, Miller MJ, Evans GR, Robb GL, et al. Comparison of resource costs of immediate and delayed breast reconstruction. Plast Reconstr Surg. 1998;101(4):964–8.
AGO Breast Committee. Diagnosis and treatment of patients with early and advanced breast cancer. Version 2022.1. www.ago-online.de. Accessed August 15, 2023.
Munhoz AM, Montag E, Fels KW, et al. Outcome analysis of breast-conservation surgery and immediate latissimus dorsi flap reconstruction in patients with T1 to T2 breast cancer. Plast Reconstr Surg. 2005;116(3):741–52.
Rainsbury RM. Breast-sparing reconstruction with latissimus dorsi miniflaps. Eur J Surg Oncol. 2002;28(8):891–5.
Berthet G, et al. Tolerance of latissimus dorsi flap in immediate breast reconstruction to radiotherapy. J Plast Reconstr Aesthet Surg. 2018 Jan;71(1):15-20.
Liu Q, Xu J, Wu S, Liu G, Wang L, Chen L. Immediate breast reconstruction using latissimus dorsi muscular flap: A retrospective study of Chinese patients with breast cancer. Medicine (Baltimore). 2021 Jun 18;100(24):e26175.
Noone RB, Frazier TG, Noone GC, Blanchet NP, Murphy JB, Rose D. Recurrence of breast carcinoma following immediate reconstruction: a 13-year review. Plast Reconstr Surg. 1994;93(1):96–106.
Ofri A, et al. Neoadjuvant chemotherapy in non-metastatic breast cancer: The surgeon's perspective. Surgery. 2023 Dec;21(6):356-360.
Mohamed A, Saleh M. Esthetic outcomes of using latissimus dorsi flap for breast reconstruction after breast conserving surgery. The Egyptian Journal of Surgery. 2019;38(4):643-655.
Kopkash K, Clark P. Basic Oncoplastic surgery for breast conservation: tips and techniques. Ann Surg Oncol. 2018;25(10):2823–2828.
Houssami N, Macaskill P, Marinovich ML, Morrow M. The association of surgical margins and local recurrence in women with early-stage invasive breast cancer treated with breast-conserving therapy: a meta-analysis. Ann Surg Oncol. 2014;21(3):717-30.
Shah C, Verma V, Sayles H, Recht A, Vicini F. Appropriate margins for breast conserving surgery in patients with early stage breast cancer: a meta-analysis. Cancer Res. 2018;78(4 Suppl):Abstract GS5-01. (Presented at San Antonio Breast Cancer Symposium 2017).
André C, Holsti C, Svenner A, Sackey H, Oikonomou I, Appelgren M, et al. Recurrence and survival after standard versus oncoplastic breast-conserving surgery for breast cancer. BJS Open. 2021;5(1):zraa013.
Daltrey I, Thomson H, Hussien M, Krishna K, Rayter Z, Winters ZE. Randomized clinical trial of the effect of quilting latissimus dorsi flap donor site on seroma formation. Br J Surg. 2006;93(7):825–30.
Schneider WJ, Hill HL Jr, Brown RG. Latissimus dorsi myocutaneous flap for breast reconstruction. Br J Plast Surg. 1977;30(4):277–81.
Tomita K, Yano K, Masuoka T, Matsuda K, Takada A, Hosokawa K. Postoperative seroma formation in breast reconstruction with latissimus dorsi flaps: a retrospective study of 174 consecutive cases. Ann Plast Surg. 2007;59(2):149–51.
Lee KT, Mun GH. A systematic review of functional donor-site morbidity after latissimus dorsi muscle transfer. Plast Reconstr Surg. 2014;134(2):303-14.
Escandón JM, et al. Autologous breast reconstruction with latissimus dorsi flap in obese patients: Time-to-event analysis. J Plast Reconstr Aesthet Surg. 2023 Sep;84:605-617.
Moore TS, et al. Latissimus dorsi myocutaneous flap for breast reconstruction: long-term results. Plast Reconstr Surg. 1992 Apr;89(4):666-72.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 the Author(s).
This work is licensed under a Creative Commons Attribution 4.0 International License.
