Advertisement

Surgery Today

, Volume 44, Issue 11, pp 2098–2105 | Cite as

Oncoplastic surgery combining partial mastectomy and immediate volume replacement using a thoracodorsal adipofascial cutaneous flap with a crescent-shaped dermis

  • Yuko KijimaEmail author
  • Heiji Yoshinaka
  • Munetsugu Hirata
  • Hideo Arima
  • Akihiro Nakajo
  • Yoshiaki Shinden
  • Yoshikazu Uenosono
  • Hiroshi Okumura
  • Sumiya Ishigami
  • Shoji Natsugoe
Original Article

Abstract

Purpose

The treatment of early breast cancer using breast-conserving therapy commonly ensures local control and acceptable cosmetic results. We herein report a useful technique, including the use of a thoracodorsal adipofascial cutaneous flap for reconstructing defects in the outer quadrant area after partial mastectomy, which achieved excellent results.

Methods

We performed partial mastectomy followed by immediate volume replacement using a modified thoracodorsal adipofascial cutaneous flap with a crescent-shaped dermis in ten patients.

Results

The modified oncoplastic technique was performed without any complications in all patients. Sufficient blood flow to the cutaneous flap with the crescent-shaped dermis was visualized in two patients during the operation after the injection of indocyanine green. The oncological and cosmetic results were excellent to good in these patients.

Conclusions

Oncoplastic surgery using a modified thoracodorsal adipofascial flap with a crescent-shaped dermis was successfully performed in patients with early cancer lesions in the outer quadrant, and the cosmetic results obtained were excellent.

Keywords

Breast cancer Breast-conserving therapy Oncoplastic surgery Immediate reconstruction Volume replacement Thoracodorsal adipofascial cutaneous flap Crescent-shaped dermis 

Notes

Conflict of interest

We declare that there are no financial relationships or other interests with regard to this manuscript that may be construed as constituting a conflict of interest for any author.

References

  1. 1.
    Fisher B, Anderson S, Redmond CK, Wolmark R, Wickerham DL, Cronin WM. Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med. 1995;333:1456–61.PubMedCrossRefGoogle Scholar
  2. 2.
    Berrino P, Campora E, Santi P. Postquadrantectomy breast deformities: classification and techniques of surgical correction. Plast Reconstr Surg. 1987;79(4):567–72.PubMedCrossRefGoogle Scholar
  3. 3.
    Cooperman AM, Dinner M. The rhomboid flap and partial mastectomy. Surg Clin N Am. 1978;58:869–73.PubMedGoogle Scholar
  4. 4.
    Kijima Y, Yoshinaka H, Funasako Y, et al. Immediate reconstruction using thoracodorsal adipofascial flap after partial mastectomy. The Breast. 2009;18:126–9.PubMedCrossRefGoogle Scholar
  5. 5.
    Kijima Y, Yoshinaka H, Hirata M, Mizoguchi T, Ishigami S, Arima H, Nakajo A, Ueno S, Natsugoe S. Immediate reconstruction using a modified inframammary adipofascial flap after partial mastectomy. Surg Today. 2012;43(4):456–60.PubMedCrossRefPubMedCentralGoogle Scholar
  6. 6.
    Sobin LH, Wittwkind CH. TNM Classification of Malignant Tumours. 7th ed. Oxford: Wiley; 2009.Google Scholar
  7. 7.
    Kijima Y, Yoshinaka H, Hirata M, Mizoguchi T, Ishigami S, Arima H, Nakajo A, Ueno S, Natsugoe S. Immediate reconstruction using a modified thoracodorsal adipofascial cutaneous flap after partial mastectomy. Breast. 2011;20:464–7.PubMedCrossRefGoogle Scholar
  8. 8.
    Japanese Breast Cancer Society. Cosmetic assessment after breast conserving surgery. The 12th annual meeting of the Japanese Breast Cancer Society 2004; pp. 107-9.Google Scholar
  9. 9.
    Longacre JJ. Correction of the hypoplastic breast with special reference to reconstruction of the “nipple type breast” with local dermo-fat pedicle flap. Plast Reconstr Surg. 1954;14:431–41.CrossRefGoogle Scholar
  10. 10.
    Audretsch WP, Rezai M, Kolotas C, Zamboglou N, Schnabel T, Bojar H. Onco-plastic surgery: “target” volume reduction (BCT-mastopexy), lumpectomy reconstruction (BCT-reconstruction) and flap-supported operability in breast cancer. Proceeding 2nd European Congress on Senology; Oct 2–6, 1994; Vienna, Austria. p 139-57.Google Scholar
  11. 11.
    Audretsch WP, Rezai M, Kolotas C, Zamboglou N, Schnabel T, Bojar H. Tumor-specific immediate reconstruction in breast cancer patients. Perspect Plast Surg. 1998;11:71–106.Google Scholar
  12. 12.
    Kijima Y, Yoshinaka H, Funasako Y, Natsugoe S, Aikou T. Oncoplastic surgery after mammary reduction and mastopexy for bilateral breast cancer lesions: report of a case. Surg Today. 2008;35:335–9.CrossRefGoogle Scholar
  13. 13.
    Kijima Y, Yoshinaka H, Ishigami S, et al. Oncoplastic surgery for Japanese patients with ptotic breasts. Breast Cancer. 2011;18:273–81.PubMedCrossRefGoogle Scholar
  14. 14.
    Kijima Y, Yoshinaka H, Hirata M, et al. Oncoplastic surgery combining partial mastectomy with breast reconstruction using the free nipple-areola graft technique for a Japanese patient with DCIS in a ptotic breast: a case report. Surg Today. 2011;41:390–5.PubMedCrossRefGoogle Scholar
  15. 15.
    Kijima Y, Yoshinaka H, Hirata M, Mizoguchi T, Ishiami S, Nakajo A, Arima H, Ueno S, Natsugeo S. Oncoplastic surgery for Japanese patients with breast cancer of the lower pole. Surg Today. 2011;41:1461–5.PubMedCrossRefGoogle Scholar
  16. 16.
    Early Breast Cancer Trialists’ Collaborative Group (EBCTCG), Correa C, McGale P, Taylor C, Wang Y, Clarke M, Davies C, et al. Overview of the randomized trials of radiotherapy in ductal carcinoma in situ of the breast. J Natl Cancer inst Monogr. 2010;41:162–77.Google Scholar
  17. 17.
    Hughes LL, Wang M, Page DL, Gray R, Solin LJ, Dabvidson NE, Lowen MA, et al. Local excision alone without irradiation for ductal carcinoma in situ of the breast: a trial of the Eastern cooperative oncology group. J Clin Oncol. 2009;27(32):5319–24.PubMedCrossRefPubMedCentralGoogle Scholar
  18. 18.
    Handa T, Katare RG, Nishimori H, Wariishi S, Fukutoi T, Yamamoto M, Sasaguri S, Sato T. New device for intraoperative graft assessment: HyperEye charge-coupled device camera system. Gen Thorac Cardiovasc Surg. 2010;58:68–77.PubMedCrossRefGoogle Scholar
  19. 19.
    Kubota K, Yoshida M, Kuroda J, Okada A, Ohta K, Kitajima M. Applications of the HyperEye Medical System for esophageal cancer surgery: a preliminary report. Surg Today. 2013;43(2):215–20.PubMedCrossRefGoogle Scholar
  20. 20.
    Hoffmann J, Wallwiener D. Classifying breast cancer surgery: a novel, complexity-based system for oncological, oncoplastic and reconstructive procedures, and proof of principle by analysis of 1225 operations in 1166 patients. BMC Cancer. 2009;9:108.PubMedCrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer Japan 2013

Authors and Affiliations

  • Yuko Kijima
    • 1
    Email author
  • Heiji Yoshinaka
    • 1
  • Munetsugu Hirata
    • 1
  • Hideo Arima
    • 1
  • Akihiro Nakajo
    • 1
  • Yoshiaki Shinden
    • 1
  • Yoshikazu Uenosono
    • 1
  • Hiroshi Okumura
    • 1
  • Sumiya Ishigami
    • 1
  • Shoji Natsugoe
    • 1
  1. 1.Department of Digestive Surgery, Breast and Thyroid SurgeryKagoshima University Graduate School of Medical and Dental SciencesKagoshimaJapan

Personalised recommendations