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Breast Cancer

, Volume 26, Issue 5, pp 595–601 | Cite as

Lateral thoracoaxillar dermal-fat flap for breast conserving surgery: the changes of the indication and long-term results

  • Hiroshi NakagomiEmail author
  • Masayuki Inoue
  • Haruka Nakada
  • Masato Ohmori
  • Yuko Nakayama
  • Kazushige Furuya
  • Hideki Watanabe
  • Kou Ikegame
  • Koichi Kobayashi
Original Article
  • 70 Downloads

Abstract

Background

Oncoplastic breast conserving surgery had been challenged to achieve both of local control and the cosmetic appearance of preserved breast. We developed the lateral thoracoaxillar dermal-fat flap (LTDF) as an oncoplastic procedure to fill the defect of breast-conserving surgery in 1999.

Methods

A total of 2338 breast cancer patients underwent surgery from January, 2000 to December, 2017. Mastectomy was performed in 706 patients (30%), and breast conservative surgery (BCS) was performed in 1634 patients (70%). The LTDF was adopted in 487/1634 (30%) of BCS cases to fill the large defect left by partial resection. we divided all patients into 3 groups: breast total mastectomy (BT group), the breast partial resection (BP) with LTDF (LTDF group), and Bp without LTDF (BP group) and compared the clinical characteristics, and recurrence rate.

Results

The Indications for LTDF increased up to 40% in 2010, while they decreased to 20%–30% in the most recent period, in accordance with the frequency of breast reconstruction increased. Patients who underwent BP + LTDF (LTDF group) included significantly higher proportions of stage II diseases and cases treated by neoadjuvant chemotherapy than those in BP or BT groups.. We found no marked difference of local recurrence and distant metastases between the LTDF and Bp groups. However, the rate of distant metastasis was significantly higher in BT group than in the Bp or LTDF group. Concerning the complications of LTDF, we experienced a few complications of Grade 3–4 requiring surgical management, namely one case of dislocation of the LTDF, three cases of bleeding, and five cases each of skin necrosis and fat necrosis.

Conclusions

We reported satisfying long-term outcomes of 487 cases treated by LTDF. LTDF is a suitable oncoplastic technique for BCS.

Keywords

Breast-conserving oncoplastic surgery Lateral thoracoaxillar dermal-fat flap Long-term results 

Notes

Acknowledgements

This study was approved by the institutional review board at Yamanashi Central Hospital.

Compliance with ethical standards

Conflict of interest

The authors have declared no conflicts of interest.

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Copyright information

© The Japanese Breast Cancer Society 2019

Authors and Affiliations

  1. 1.Department of Breast SurgeryYamanashi Prefectural Central HospitalKofuJapan
  2. 2.Department of Plastic SurgeryYamanashi Prefectural Central HospitalKofuJapan
  3. 3.First Department of SurgeryYamanashi UniversityKofuJapan

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