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Postoperative Cancer Surveillance Following Oncoplastic Surgery with Latissimus Dorsi Flap: a Matched Case–Control Study

  • Kenneth L. Fan
  • Simon Yang
  • Seho Park
  • Tae Hwan Park
  • Seung Yong Song
  • Nara Lee
  • Dae Hyun Lew
  • Min Jung KimEmail author
  • Dong Won LeeEmail author
Reconstructive Oncology
  • 1 Downloads

Abstract

Background

The latissimus dorsi (LD) myocutaneous flap is a widely used local option in oncoplastic surgery for avoiding breast deformities; however, concerns exist regarding its influence in monitoring recurrence. In this study, we evaluated the impact of this flap on postoperative cancer surveillance.

Methods

Each patient receiving oncoplastic surgery with LD flap after partial mastectomy were matched in age, cancer stage, and body mass index with patients receiving partial mastectomy alone. Twenty-nine patients with the oncoplastic LD flap received 99 mammograms and 139 ultrasonograms, while 29 patients with partial mastectomy alone underwent 92 mammograms and 129 ultrasonograms. Mammographic and ultrasonographic findings were classified by Breast Imaging Reporting and Data System (BI-RADS) category and reviewed. Any recommendations for additional evaluation and recurrence were documented.

Results

During an average follow-up period of 44 months, although the oncoplastic group demonstrated more newly developed benign calcifications (control 14% vs. oncoplastic 41%; p = 0.019) on mammography, the percentage of recall for additional imaging in category 0, and the short-interval follow-up in category 3, was not different between the control and oncoplastic group. Regarding ultrasonography, BI-RADS category was also not different between the two groups; however, the control group showed more fluid collections than the oncoplastic group (control 21% vs. oncoplastic 0%; p = 0.023). One case of local recurrence was observed in the control group.

Conclusion

Although there was an increase in benign calcifications in the oncoplastic group, there were no additional abnormal findings requiring further intervention. We concluded that the LD flap for oncoplastic surgery does not interfere with cancer surveillance, and even decreases the rate of fluid collection.

Notes

Acknowledgment

This study was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2018R1D1A1B07049448).

DISCLOSURES

Kenneth L. Fan, Simon Yang, Seho Park, Tae Hwan Park, Seung Yong Song, Nara Lee, Dae Hyun Lew, Min Jung Kim, and Dong Won Lee have no conflicts of interest or financial ties to disclose.

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Copyright information

© Society of Surgical Oncology 2019

Authors and Affiliations

  1. 1.Department of Plastic and Reconstructive SurgeryMedStar Georgetown University HospitalWashingtonUSA
  2. 2.Department of Plastic and Reconstructive Surgery, and Institute for Human Tissue RestorationYonsei University College of MedicineSeoulKorea
  3. 3.Division of Breast Surgery, Department of SurgeryYonsei University College of MedicineSeoulKorea
  4. 4.Division of Public Health Sciences, Department of SurgeryWashington University School of MedicineSt. LouisUSA
  5. 5.Department of Plastic and Reconstructive SurgeryCHA Bundang Medical Center, CHA UniversitySeongnamKorea
  6. 6.Department of Radiology, Research Institute of Radiologic ScienceYonsei University College of MedicineSeoulKorea

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