A novel oncoplastic technique for centrally located breast cancers: An experience from a Tertiary care center in North India.

Abstract

Context: Oncoplastic breast surgery is the current standard for treatment of early breast cancer, offering a balance between good cosmetic outcomes and limited risk of locoregional recurrence. Still, the best technique of reconstruction for centrally located breast cancer (CLBC) is not established because of cosmetic issues associated with NAC resection and difficulties associated with its reconstruction.

Aims: This study aims to present here a novel technique of post-BCS breast reconstruction for CLBC by latissimus dorsi (LD) flap coupled with immediate NAC reconstruction using modified Skate Flap.

Methods and material: A total of 9 patients underwent oncoplastic breast reconstruction using the described technique for CLBC at our center from July 2018 to March 2020. Postoperative analysis was done for surgical complications, pathological, oncological, and cosmetic outcomes. QOL outcome was assessed using body image scale (BIS) and compared with another group of 9 mastectomy patients operated in the same time period.

Statistical analysis: The analysis was done using SPSS software. P value was calculated using the Independent t-test.

Results: Mean BIS score was 4.44 (range 1-8) in BCS vs 20 (range 11-27) in the mastectomy group, signifying better QOL in the BCS group. The postoperative cosmetic results, as evaluated by the patients, were excellent in 7 of 9 patients (77.77%), good in 1 patient (11.11%), and fair in 1 (11.11%), with an overall mean of 4.11 equivalent to 82% satisfaction.

Conclusions: Immediate reconstruction with LD flap and modified skate flap following resection of CLBC is a good technique for this difficult group of patients to be managed by BCS. Cosmetic results of this technique are satisfactory. Additionally, it avoids the need for a symmetrizing contralateral breast surgery as well as a second surgery on the ipsilateral breast.