A single centre experience of local perforator flaps in oncoplastic breast surgery

Dr Sana Zeeshan, Dr Lubna Vohra, Dr Danish Ali et al.

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Background & Objectives

Various oncoplastic techniques have emerged over the years to preserve breast cosmesis and symmetry without compromising the principles of tumour excision. One of the newer techniques for breast volume replacement to achieve symmetry and cosmesis is the use of fasciocutaneous pedicled chest wall perforator flaps or local perforator flaps (LPF). The objectives of this study were to document the details of the surgical procedure as well as patient-reported satisfaction and well-being following the procedure using a validated BREAST-Q tool among Pakistani women.
Materials & Methods

This prospective cross-sectional study was conducted from March 2019 to February 2021 enrolling 25 female patients who underwent LPF for breast tumours at The Aga Khan University Hospital, Karachi, Pakistan. Data related to the procedure was collected on a pre-designed proforma. Cosmetic outcomes and patient satisfaction were evaluated using 2 scales from BREAST-Q BCT domain version 2.0. The questionnaire was self-administered by the patients during their routine follow-up in the clinic. Data was analysed using the Statistical Package for Social Sciences (SPSS) version 23. Mean (SD) / median (IQR) were computed for quantitative variables and frequency and percentages were calculated for qualitative variables. 2 sample t-test was applied. P-value ≤0.05 was considered significant.

25 patients underwent LPF with a mean age of 47 ± 13.1 years. 8 LICAP, 7 AICAP, and 10 LTAP flaps were performed. No postoperative complications were encountered. 23 women were eligible for the BREAST-Q survey. Median (IQR) postoperative satisfaction with breasts and physical well-being chest (equivalent Rasch transformed score) was 100 (41) and 76 (18) respectively. We found high satisfaction with breasts and comparable physical well-being among Pakistani women after LPF surgeries.

Local perforator flaps in oncoplastic breast-conserving surgery are a good option showing high satisfaction with breasts and physical well-being in Pakistani women.

Strengths: This is the first study of its kind being reported from our part of the world, with no previous publication on LPF from Pakistan, and the only study in which patient satisfaction and physical well-being were assessed after LPF for partial breast reconstruction using BREAST-Q to the best of our knowledge. The study findings are consistent with other studies showing that BREAST-Q is a good tool for assessment of patient satisfaction and well-being after different surgical procedures in breast tumour cases.

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