Abstract
To describe the technique and outcome of local perforator arteries advancement flap in breast-conserving surgeries (BCS) in patient of early breast cancer as our initial experience and review of literature on it. Patients who underwent (BCS) with local perforator artery flap reconstruction were reviewed in terms of their clinical, surgical, and post-operative follow-up details after taking written and informed consent. We have described 4 patients of early breast cancer out of which one patient was post-NACT while 3 were for upfront BCS. We have performed LICAP in 2 patients, AICAP in 1 patient, and IMAP in one patient, depending on the location of primary tumors. None of the patients had any major or minor surgical complications in the post-operative period and drains were removed on post-operative day 2. All patients received post-operative radiotherapy and tolerated well without any loco-regional complications. Patients are in routine follow-up with cosmetic satisfaction without any local recurrence over 1 year. The main advantages of pedicled perforator flaps are well-vascularized tissue, spares underlying muscle leading to lesser donor site morbidity like muscle function and seroma formation, easily reach the breast area with good match in terms of skin and subcutaneous tissue, faster recovery, and shorter learning curve in comparison to free flaps. Knowledge and skill about these flaps will help surgeon to give better surgical outcomes and satisfaction to patients.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Mamounas EP (2003) NSABP breast cancer clinical trials: recent results and future directions. Clin Med Res 1(4):309–326
Baghaki S, Diyarbakirlioglu M, Sahin U, Kucuksucu MA, Turna A, Baca B et al (2017) Extended locoregional use of intercostal artery perforator propeller flaps. Microsurgery 37(4):293–299
Hamdi M, Van Landuyt K, Monstrey S, Blondeel P (2004) Pedicled perforator flaps in breast reconstruction: a new concept. Br J Plast Surg 57(6):531–539
Gillis JA, Prasad V, Morris SF (2011) Three-dimensional analysis of the internal mammary artery perforator flap. Plast Reconstr Surg 128(5):419e-e426
Clough KB, Kaufman GJ, Nos C, Buccimazza I, Sarfati IM (2010) Improving breast cancer surgery: a classification and quadrant per quadrant atlas for oncoplastic surgery. Ann Surg Oncol 17(5):1375–1391
Clough KB, Cuminet J, Fitoussi A, Nos C, Mosseri V (1998) Cosmetic sequelae after conservative treatment for breast cancer: classification and results of surgical correction. Ann Plast Surg 41(5):471–481
Kerrigan CL, Daniel RK (1979) The intercostal flap: an anatomical and hemodynamic approach. Ann Plast Surg 2(5):411–421
Yu BT, Hsieh CH, Feng GM, Jeng SF (2013) Clinical application of the internal mammary artery perforator flap in head and neck reconstruction. Plast Reconstr Surg 131(4):520e-e526
Vesely MJ, Murray DJ, Novak CB, Gullane PJ, Neligan PC (2007) The internal mammary artery perforator flap: an anatomical study and a case report. Ann Plast Surg 58(2):156–161
Schmidt M, Aszmann OC, Beck H, Frey M (2010) The anatomic basis of the internal mammary artery perforator flap: a cadaver study. J Plast Reconstr Aesthet Surg 63(2):191–196
Hakakian CS, Lockhart RA, Kulber DA, Aronowitz JA (2016) Lateral intercostal artery perforator flap in breast reconstruction: a simplified pedicle permits an expanded role. Ann Plast Surg 76(Suppl 3):S184–S190
Soumian S, Parmeshwar R, Chandarana M, Marla S, Narayanan S, Shetty G (2020) Chest wall perforator flaps for partial breast reconstruction: surgical outcomes from a multicenter study. Arch Plast Surg 47(2):153–159
Quinn EM, Burrah R, O’Ceallaigh S, Highton L, Murphy J (2021) Six-year experience of oncoplastic volume replacement using local perforator flaps. J Plast Reconstr Aesthet Surg 74(9):2184–2193
Huizum MAV, Hage JJ, Oldenburg HA, Hoornweg MJ (2017) Internal mammary artery perforator flap for immediate volume replacement following wide local excision of breast cancer. Arch Plast Surg 44(6):502–508
Losken A, Dugal CS, Styblo TM, Carlson GW (2014) A meta-analysis comparing breast conservation therapy alone to the oncoplastic technique. Ann Plast Surg 72(2):145–149
Veiga DF, Veiga-Filho J, Ribeiro LM, Archangelo I Jr, Balbino PF, Caetano LV et al (2010) Quality-of-life and self-esteem outcomes after oncoplastic breast-conserving surgery. Plast Reconstr Surg 125(3):811–817
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethics Approval
Patient were taken into study after written and informed consent. No institute ethical clearance required.
Conflict of Interest
The authors declare no competing interests.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Singh, A.P., Seenu, V., Krishna, A. et al. Local Flaps in Breast-Conserving Surgery in Early Breast Cancer Patients: Armamentarium for Breast Surgeon. Indian J Surg Oncol 15, 258–263 (2024). https://doi.org/10.1007/s13193-024-01880-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13193-024-01880-7