Abstract
Since 2003, oncoplastic breast surgery was introduced combining breast cancer resection and reconstruction. The goal of OBS is to achieve an oncologically safe surgery with the best possible cosmetic result. This type of procedure must be carefully planned preoperatively by taking into account several factors. However, sometimes this does not happen, and as a response to this factors’ neglect, we developed a technique to correct the defect from an upper quadrant breast cancer lumpectomy, which resulted to be wider than expected. This technique is called the horseshoe flap. Data were collected retrospectively from the Teramo Breast Unit database from June 2013 to December 2014. Both preoperative and postoperative data were recorded. The horseshoe flap was used in resections of 20 % or more of the breast volume and consisted in the dissection of the remaining breast tissue from the overlying skin flap, and the mobilization of the remaining part of the upper pole from the pectoralis muscle. The two upper extremities were folded to cover the substance loss in the lumpectomy. A total of five patients underwent a horseshoe flap to correct their defect resulting for an upper quadrant cancer excision. Average resection volume was 131 cc, and no poor or bad cosmetic results were observed. During the follow-up, no cancer recurrences were observed. Sometimes breast surgeons need to perform resections larger than expected, and we are challenged with the correction of the defect without the possibility of a preoperative planning. In this pilot work, we present a valid solution for this situation in case cancers are located in the upper quadrants of the breast.
Level of Evidence: Level IV, therapeutic study.
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Aknowledgments
We express our sincere thanks to Davide Baroni of the Ohio University, USA, for the kindness and readiness with which she helped us to improve the quality of this work, by suggesting a better and more fluent style of writing.
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Guido Torresini, Maurizio Brucchi, Emanuele Garreffa, and Antonella Sozio declare that they have no conflict of interest.
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This study has been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
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Torresini, G., Brucchi, M., Garreffa, E. et al. The horseshoe flap. An “emergency” oncoplastic breast surgery technique. Eur J Plast Surg 39, 375–382 (2016). https://doi.org/10.1007/s00238-016-1186-6
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DOI: https://doi.org/10.1007/s00238-016-1186-6