ABSTRACT
Objective To evaluate the value of reconstruction of submammary fold with lateral thoracic wall adipofascial flap after nipple-areola complex sparing mastectomy (NSM) in elderly patients with breast cancer.Methods To retrospective analysis 20 cases of elderly patients with breast cancer were admitted from March 2016 to June 2018 in Beijing Tongren Hospital,Capital Medical University using reconstruction of submammary fold with lateral thoracic wall adipofascial flap after NSM (study group).Twenty-two elderly patients with breast cancer who had breast-conserving and sentinel lymph node biopsy were selected as control group.The operation time,drainage tube retention time,postoperative hospitalization time,postoperative complications,breast contour satisfaction were statistically analyzed.The measurements were expressed as mean ± standard deviation (Mean ± SD),and t-test was used for inter-group comparison,and Chi-square test was used for inter-group comparison of counting data.Results All cases were followed up for 3-27 months without local recurrence and distant metastasis.The difference in operative time between the study group and control group was statistically significant [(2.085 ±0.163 1) h vs (1.918 ± 0.159 3) h,P =0.002].There was no significant difference between the study group and control group in drainage tube removal time(5.25 ± 0.910) d vs (5.27 ± 0.767) d,hospitalization days (6.25 ± 0.910) d vs (6.27 ± 0.767) d,breast contour satisfaction rate (90.0％ vs 81.8％) (P ＞ 0.05).Postoperative necrosis and liquefaction of adipofascial flaps occurred in 1 case in the study group and delayed healing occurred.Conclusion For some early-stage elderly breast cancer,reconstruction of submammary fold with lateral thoracic wall adipofascial flap after NSM,at the same time of radical surgery,can ensure the basic breast shape,avoid the chest wall deformity caused by traditional radical mastectomy,and improve the appearance and quality of life after mastectomy.
ABSTRACT
Objective To explore the operative indication , therapeutic effects and feasibility of immedi-ate mammoplasty with lateral thoracic steato-fascia flap.Methods A retrospective study was carried out on clini-copathologic data of 26 patients receiving nipple-areola complex preserving modified radical mastectomy and im-mediate mammoplasty with lateral thoracic wall adipofascial flap and 5 patients receiving segmental mastectomy and immediate mammoplasty with lateral thoracic wall adipofascial flap because of benign breast diseases .In these patients receiving nipple-areola complex preserving modified radical mastectomy , 22 patients received lateral tho-racic wall adipofascial flap , and 4 patients received lateral thoracic wall adipofascial flap combined with silicone prosthesis .The surgical complications and cosmetic effects were evaluated by both subjective and objective stand -ard postoperatively .Results 24 patients were satisfied with the appearance of their breasts and the two sides seemed to be symmetrical .There was no flap or nipple necrosis .The patients received adjuvant chemotherapy after surgery.No local recurrence or distant metastasis occurred during the follow up (2 to 12 months).Five patients with benign breast diseases were very satisfied with their breast appearance after surgery .Conclusion For patients in early stage breast cancer receiving modified radical mastectomy with nipple-areolar complex preserved and patients with benign breast diseases having segmental mastectomy , immediate mammoplasty with lateral thoracic wall adipo-fascial flap is a good method which can help to keep well breast apperance without additional incision , and it is also economical , feasible , and can reduce patients'psychological pressure due to loss of the breast .