Annals of Surgical Oncology

, Volume 3, Issue 4, pp 375–380

Immediate breast reconstruction for stage III breast cancer using transverse rectus abdominis musculocutaneous (TRAM) flap

  • Toncred M. Styblo
  • Melinda M. Lewis
  • Grant W. Carlson
  • Douglas R. Murray
  • William C. Wood
  • David Lawson
  • Jerome Landry
  • Lorie Hughes
  • Foad Nahai
  • John BostwickIII
Original Articles

DOI: 10.1007/BF02305667

Cite this article as:
Styblo, T.M., Lewis, M.M., Carlson, G.W. et al. Annals of Surgical Oncology (1996) 3: 375. doi:10.1007/BF02305667

Abstract

Background: The management of stage III breast cancer is challenging; it often includes multimodal treatment with systemic therapy and/or radiation therapy and surgery. Immediate breast reconstruction has not traditionally been performed in these patients. We review the results of immediate transverse rectus abdominis musculocutaneous (TRAM) flap in 21 patients treated for stage III breast cancer.

Methods: Data have been collected retrospectively on 21 patients diagnosed with stage III breast cancer between 1987 and 1994. All patients had mastectomy and immediate TRAM reconstruction. Thirteen patients received primary systemic therapy, 10 patients received postoperative consolidation radiotherapy to the operative site, and 3 patients received preoperative radiation.

Results: Mean follow-up for the group was 26 months. Two patients died with disseminated disease: neither of them developed local disease recurrence in the operative site; 82% of the patients followed for at least two years are free of disease. Sixty-two percent of the patients received preoperative chemotherapy, the remaining patients received postoperative multiagent chemotherapy and/or radiation therapy. Two of the patients received autologous bone marrow transplants after their adjuvant therapy. Ten patients had postoperative radiotherapy for consolidation; three patients received preoperative radiation.

Conclusions: Immediate TRAM reconstruction for stage III breast cancer is not associated with a delay in adjuvant therapy or an increased risk of local relapse. It facilitates wide resection of involved skin without skin grafting. Radiation therapy can be delivered to the reconstructed breast when indicated without difficulty. Breast reconstruction facilitates surgical resection of stage III breast cancer with primary closure and should be considered if the patient desires immediate breast reconstruction.

Key Words

Stage III breast cancer Breast reconstruction TRAM flap 

Copyright information

© The Society of Surgical Oncology, Inc. 1996

Authors and Affiliations

  • Toncred M. Styblo
    • 2
  • Melinda M. Lewis
    • 1
  • Grant W. Carlson
    • 2
    • 3
  • Douglas R. Murray
    • 2
  • William C. Wood
    • 2
  • David Lawson
    • 4
  • Jerome Landry
    • 5
  • Lorie Hughes
    • 5
  • Foad Nahai
    • 3
  • John BostwickIII
    • 3
  1. 1.From the Department of PathologyEmory UniversityAtlantaUSA
  2. 2.the Department of SurgeryEmory UniversityAtlantaUSA
  3. 3.the Department of Plastic and Reconstructive SurgeryEmory UniversityAtlantaUSA
  4. 4.the Department of Hematology/OncologyEmory UniversityAtlantaUSA
  5. 5.the Department of Radiation OncologyEmory UniversityAtlantaUSA

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