Abstract
Background
Immediate reconstruction with autogenous tissue is one of the options for reconstruction following breast-conservation surgery for breast cancers in major centres with ready availability of appropriate skills. Immediate correction of volume deficit by latissimus dorsi miniflap (LDMF) in addition has cosmetic appeal by filling the defect without extra skin incision.
Methods
Data was collected retrospectively from clinical records of 51 patients who underwent LDMF procedures in a district general hospital between June 2000 and December 2004, and the results were analysed. Postal questionnaire survey was done to assess the level of subjective satisfaction of the cosmetic outcome.
Results
Wide local excision and axillary-node sampling/clearance along with immediate reconstruction with a LDMF (involving a musculo-subcutaneous flap without skin) were performed in all patients. Patients’ median age was 50 years. Sixty-five percent of the tumours were in the upper–outer quadrant, median weight of the specimen was 217.5 g (31–510 g), median clearance margin was 5 mm (0–15 mm) and median pathological size of the tumour was 20 mm (8–60 mm). Four patients required mastectomy later, whereas 1 patient had flap necrosis. At a median follow-up of 33 months, there has been no recurrence. Eighty-six percent of the patients who responded to the postal survey were satisfied with the cosmetic outcome.
Conclusion
Immediate LDMF reconstruction is an acceptable way of correcting deformity after breast-conservation surgery. We demonstrate by our experience that it is a viable option for breast cancer in small district hospitals/ breast units.
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Acknowledgments
This study was conducted in the Department of Surgery, Bassetlaw District General Hospital. The first two authors (C. Navin and A. Agrawal) contributed equally to the article. Navin conducted the survey, collected clinical data and analysed/interpreted and finalised data with Agrawal. Agrawal conceptualised, drafted and finalised the manuscript and analysed/interpreted and finalised data with Navin. K.M. Kolar was the operating surgeon, supervised data collection, revised the manuscript for intellectual content and approved the final version. The authors would like to thank Julie Pridmore for her administrative assistance in preparation of the manuscript.
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C. Navin and A. Agrawal Contributed equally
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Navin, C., Agrawal, A. & Kolar, K.M. The Use of Latissimus Dorsi Miniflap for Reconstruction Following Breast-conserving Surgery: Experience of a Small Breast Unit in a District Hospital. World J. Surg. 31, 46–50 (2007). https://doi.org/10.1007/s00268-006-0396-7
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DOI: https://doi.org/10.1007/s00268-006-0396-7