Role of chest wall perforator flaps in breast-conserving surgery as a volume-replacement oncoplastic procedure

Abstract

Background Partial breast reconstruction using chest wall perforator flaps (CWPF) is a recent technique used by breast surgeons, mainly for lateral defects with a relatively large volume of excision in small-sized to medium-sized breast. We report our experience of CWPF in breast reconstruction with surgical details, complications, different locations of the tumor, and outcomes. Patients and methods This was a prospective observational cohort study on 20 patients who had undergone breast-conservation surgery plus CWPF reconstruction [lateral intercostal artery perforator (LICAP) flap, lateral thoracic artery perforator (LTAP) flap, anterior intercostal artery perforator flap, and thoracodorsal artery perforator flap]. A survey was done to analyze patient satisfaction at about 6 months after completion of radiotherapy. Results LICAP flap was used in 30% of the patients, anterior intercostal artery perforator flap was used in another 30%, whereas thoracodorsal artery perforator flap was used in 25% of the patients. A combination between LTAP and LICAP was used in 10% of the studied patients, and LTAP alone was used in only 5% of the cases. Regarding the complications, there was no incidence of total or partial flap loss in this series. Only minor complications were reported. Patients’ satisfaction was assessed by a questionnaire, which showed acceptable patient satisfaction. Conclusion CWPF procedures show good outcomes in partial breast reconstruction in terms of oncological safety and patient satisfaction, extending the options for breast conservation to many patients who would otherwise require mastectomy.