Reconstruction of chest wall after extended resection for breast cancer

Dr Aditya Vora and Dr Saumya Mathews
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Introduction 

Locally advanced breast cancer (LABC) is still a common problem in developing countries. Extensive resections are aimed at local control and improving quality of life and hence there is a need for large locoregional or free flaps.


Material and methods 

Study - Retrospective observational study from 2017 to 2020.
Total flaps – 41 who were operated for either radical mastectomy or palliative mastectomy


Results 

Flap survival rate was 97.56% (40) & failure rate was 2.43% (1).
Re-explorations – 4(9.75%). Most common cause of re-exploration - venous congestion (2).
Of them 3 flaps were salvaged. 
Most common flap used - free ALT flap (58.53%) followed by pedicled latissimus dorsi (26.82%). The average flap size was 23 x 12 cm.
Most common vessels used for anastomosis - internal mammary vessels. Donor site morbidity was 5%. 


Conclusion

Large chest wall defects after breast cancer resection can be safely reconstructed with locoregional or free flaps with minimal donor site morbidity.

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