Application of Adjacent Tissue Flap in Reconstruction of Breast Defect Following Breast Conserving Surgery for Early Breast Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 杨秀春 ^1,2 ,  康骅 ¹ ,  YANGXiu-chun ^1,2 ,  KANGHua ¹

1. ;
2. ;
1. ;
2. ;

Corresponding author：

杨秀春, Email: xiuchun898@126.com; 康骅, Email: kanghua@xwh.ccum.edu.cn; YANGXiu-chun, Email: xiuchun898@126.com; KANGHua, Email: kanghua@xwh.ccum.edu.cn

Keywords：

Breast cancer; Breast conserving surgery; Breast defect; Oncoplastic technique; Adjacent tissue flap

DOI：

10.7507/1007-9424.20150366

Video：

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Objective To summarize the application of adjacent tissue flap for reconstruction of partial breast defect in breast conserving surgery. Methods The relevant literatures in recent 5 years were reviewed, and the oncoplastic techniques, classification of the adjacent tissue flaps, were summarized. Furthermore, the indications, advantages and disadvantages of the adjacent tissue flaps were evaluated. Results Currently, there were various ways to reconstruct the breast defect following breast conserving surgery. For the patient, whose breast defect volume was bigger, the application of the adjacent tissue flap was one of the effective methods to obtain better aesthetic outcomes. The adjacent tissue flaps included the following:the lateral thoracodorsal fasciocutaneous flap, thoracodorsal artery perforator flap, inframammary adipofascial flap of the anterior rectus sheath, inter-costal artery perforator flap, internal mammary artery pedicled fasciocutaneous island flap, and so on. Conclusion The adjacent tissue flap replacement technique in breast conserving surgery for reconstruction of the breast defect is a safe and effective procedure, and patients are satisfied with breast shape and overall cosmetic outcomes for it.

Citation： 杨秀春, 康骅, YANGXiu-chun, KANGHua. Application of Adjacent Tissue Flap in Reconstruction of Breast Defect Following Breast Conserving Surgery for Early Breast Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(11): 1390-1396. doi: 10.7507/1007-9424.20150366 Copy

1.	Chirappapha P, Kongdan Y, Vassanasiri W, et al. Oncoplastic technique in breast conservative surgery for locally advanced breast cancer. Gland Surg, 2014, 3(1):22-27.
2.	Blondeel PN, Hijjawi J, Depypere H, et al. Shaping the breast in aesthetic and reconstructive breast surgery:an easy three-step principle. PartⅢ-reconstruction following breast conservative treatment. Plast Reconstr Surg, 2009, 124(1):28-38.
3.	Munhoz AM, Montag E, Filassi JR, et al. Current approaches to managing partial breast defects:the role of conservative breast surgery reconstruction. Anticancer Res, 2014, 34(3, SI):1099-1114.
4.	Fitoussi AD, Berry MG, Famà F, et al. Oncoplastic breast surgery for cancer:analysis of 540 consecutive cases[outcomes article]. Plast Reconstr Surg, 125(2):454-462.
5.	Losken A, Schaefer TG, Newell M, et al. The impact of partial breast reconstruction using reduction techniques on postoperative cancer surveillance. Plast Reconstr Surg, 2009, 124(1):9-17.
6.	Park HC, Kim HY, Kim MC, et al. Partial breast reconstruction using various oncoplastic techniques for centrally located breast cancer. Arch Plast Surg, 2014, 41(5):520-528.
7.	朱江, 康骅.乳腺癌保乳手术中乳房缺损的修复方法.中国普外基础与临床杂志, 2012, 19(7):799-804.
8.	Ogawa T, Hanamura N, Yamashita M, et al. Oncoplastic technique combining an adipofascial flap with an extended glandular flap for the breast-conserving reconstruction of small dense breasts. J Breast Cancer, 2012, 15(4):468-473.
9.	Lee JW, Kim MC, Park HY, et al. Oncoplastic volume replacement techniques according to the excised volume and tumor location in small-to moderate-sized breasts. Gland Surg, 2014, 3(1):14-21.
10.	Holmström H, Lossing C. The lateral thoracodorsal flap in breast reconstruction. Plast Reconstr Surg, 1986, 77(6):933-943.
11.	Woerdeman LA, Van Schijndel AW, Hage JJ, et al. Verifying surgical results and risk factors of the lateral thoracodorsal flap. Plast Reconstr Surg, 2004, 113(1):196-205.
12.	Munhoz AM, Montag E, Arruda EG, et al. The role of the lateral thoracodorsal fasciocutaneous flap in immediate conservative breast surgery reconstruction. Plast Reconstr Surg, 2006, 117(6):1699-1710.
13.	Maxwell GP. Iginio tansini and the origin of the latissimus dorsi musculocutaneous flap. Plast Reconstr Surg, 1980, 65(5):686-692.
14.	Munhoz AM, Montag E, Fels KW, et al. Outcome analysis of breast-conservation surgery and immediate latissimus dorsi flap reconstruction in patients with T1 to T2 breast cancer. Plast Reconstr Surg, 2005, 116(3):741-752.
15.	Kijima Y, Yoshinaka H, Hirata M, et al. Immediate reconstruction using a modified thoracodorsal adipofascial cutaneous flap after partial mastectomy. Breast, 2011, 20(5):464-467.
16.	Khoobehi K, Allen RJ, Montegut WJ. Thoracodorsal artery perforator flap for reconstruction. South Med J, 1996, 89(Suppl 10):S110.
17.	Angrigiani C, Grilli D, Siebert J. Latissimus dorsi musculocutaneous flap without muscle. Plast Reconstr Surg, 1995, 96(7):1608-1614.
18.	Schwabegger AH, Harpf C, Rainer C. Muscle-sparing latissimus dorsi myocutaneous flap with maintenance of muscle innervation, function, and aesthetic appearance of the donor site. Plast Reconstr Surg, 2003, 111(4):1407-1411.
19.	Kijima Y, Yoshinaka H, Owaki T, et al. Immediate reconstruction using inframammary adipofascial flap of the anterior rectus sheath after partial mastectomy. Am J Surg, 2007, 193(6):789-791.
20.	Ogawa T, Hanamura N, Yamashita M, et al. Usefulness of breastvolume replacement using an inframammary adipofascial flap after breast-conservation therapy. Am J Surg, 2007, 193(4):514-518.
21.	Kijima Y, Yoshinaka H, Hirata M, et al. Immediate reconstruction using a modified inframammary adipofascial flap after partial mastectomy. Surg Today, 2013, 43(4):456-460.
22.	Hamdi M, Van Landuyt K, De Frene B, et al. The versatility of the inter-costal artery perforator (ICAP) flaps. J Plast Reconstr Aesthet Surg, 2006, 59(6):644-652.
23.	Kalender V, Aydm H, Karabulut AB, et al. Breast reconstruction with the internal mammary artery pedicled fasciocutaneous island flap:description of anew flap. Plast Reconstr Surg, 2000, 106(7):1494-1498.
24.	Maillard GF. Breast reconstruction with the internal mammary artery pedicled fasciocutaneous island flap:description of a new flap. Plast Reconstr Surg, 2002, 109(3):1203-1204.
25.	Kim J, Yoo J, Lee J, et al. Oncoplastic reconstruction with superior based lateral breast rotation flap after lower quadrant tumor resection. J Breast Cancer, 2012, 15(3):350-355.
26.	Nahabedian MY. Achieving ideal breast aesthetics with autologous reconstruction. Gland Surg, 2015, 4(2):134-144.
27.	Clough KB, Kaufman GJ, Nos C, et al. Improving breast cancer surgery:a classification and quadrant per quadrant Atlas for oncoplastic surgery. Ann Surg Oncol, 2010, 17(5):1375-1391.
28.	Fujishiro S, Mitsumori M, Kokubo M, et al. Cosmetic results and complications after breast conserving therapy for early breast cancer. Breast Cancer, 2000, 7(1):57-63.
29.	Vrieling C, Collette L, Fourquet A, et al; EORTC Radiotherapy and Breast Cancer Cooperative Groups. The influence of patient, tumor and treatment factors on the cosmetic results after breastconserving therapy in the EORTC 'boost vs. no boost' trial. Radiother Oncol, 2000, 55(3):219-232.
30.	朱江, 康骅, 海涛, 等.腔镜腋窝淋巴结清扫与传统腋窝淋巴结清扫对保乳手术美容效果影响的比较.中国微创外科杂志, 2014, 14(6):498-502.

1. Chirappapha P, Kongdan Y, Vassanasiri W, et al. Oncoplastic technique in breast conservative surgery for locally advanced breast cancer. Gland Surg, 2014, 3(1):22-27.
2. Blondeel PN, Hijjawi J, Depypere H, et al. Shaping the breast in aesthetic and reconstructive breast surgery:an easy three-step principle. PartⅢ-reconstruction following breast conservative treatment. Plast Reconstr Surg, 2009, 124(1):28-38.
3. Munhoz AM, Montag E, Filassi JR, et al. Current approaches to managing partial breast defects:the role of conservative breast surgery reconstruction. Anticancer Res, 2014, 34(3, SI):1099-1114.
4. Fitoussi AD, Berry MG, Famà F, et al. Oncoplastic breast surgery for cancer:analysis of 540 consecutive cases[outcomes article]. Plast Reconstr Surg, 125(2):454-462.
5. Losken A, Schaefer TG, Newell M, et al. The impact of partial breast reconstruction using reduction techniques on postoperative cancer surveillance. Plast Reconstr Surg, 2009, 124(1):9-17.
6. Park HC, Kim HY, Kim MC, et al. Partial breast reconstruction using various oncoplastic techniques for centrally located breast cancer. Arch Plast Surg, 2014, 41(5):520-528.
7. 朱江, 康骅.乳腺癌保乳手术中乳房缺损的修复方法.中国普外基础与临床杂志, 2012, 19(7):799-804.
8. Ogawa T, Hanamura N, Yamashita M, et al. Oncoplastic technique combining an adipofascial flap with an extended glandular flap for the breast-conserving reconstruction of small dense breasts. J Breast Cancer, 2012, 15(4):468-473.
9. Lee JW, Kim MC, Park HY, et al. Oncoplastic volume replacement techniques according to the excised volume and tumor location in small-to moderate-sized breasts. Gland Surg, 2014, 3(1):14-21.
10. Holmström H, Lossing C. The lateral thoracodorsal flap in breast reconstruction. Plast Reconstr Surg, 1986, 77(6):933-943.
11. Woerdeman LA, Van Schijndel AW, Hage JJ, et al. Verifying surgical results and risk factors of the lateral thoracodorsal flap. Plast Reconstr Surg, 2004, 113(1):196-205.
12. Munhoz AM, Montag E, Arruda EG, et al. The role of the lateral thoracodorsal fasciocutaneous flap in immediate conservative breast surgery reconstruction. Plast Reconstr Surg, 2006, 117(6):1699-1710.
13. Maxwell GP. Iginio tansini and the origin of the latissimus dorsi musculocutaneous flap. Plast Reconstr Surg, 1980, 65(5):686-692.
14. Munhoz AM, Montag E, Fels KW, et al. Outcome analysis of breast-conservation surgery and immediate latissimus dorsi flap reconstruction in patients with T1 to T2 breast cancer. Plast Reconstr Surg, 2005, 116(3):741-752.
15. Kijima Y, Yoshinaka H, Hirata M, et al. Immediate reconstruction using a modified thoracodorsal adipofascial cutaneous flap after partial mastectomy. Breast, 2011, 20(5):464-467.
16. Khoobehi K, Allen RJ, Montegut WJ. Thoracodorsal artery perforator flap for reconstruction. South Med J, 1996, 89(Suppl 10):S110.
17. Angrigiani C, Grilli D, Siebert J. Latissimus dorsi musculocutaneous flap without muscle. Plast Reconstr Surg, 1995, 96(7):1608-1614.
18. Schwabegger AH, Harpf C, Rainer C. Muscle-sparing latissimus dorsi myocutaneous flap with maintenance of muscle innervation, function, and aesthetic appearance of the donor site. Plast Reconstr Surg, 2003, 111(4):1407-1411.
19. Kijima Y, Yoshinaka H, Owaki T, et al. Immediate reconstruction using inframammary adipofascial flap of the anterior rectus sheath after partial mastectomy. Am J Surg, 2007, 193(6):789-791.
20. Ogawa T, Hanamura N, Yamashita M, et al. Usefulness of breastvolume replacement using an inframammary adipofascial flap after breast-conservation therapy. Am J Surg, 2007, 193(4):514-518.
21. Kijima Y, Yoshinaka H, Hirata M, et al. Immediate reconstruction using a modified inframammary adipofascial flap after partial mastectomy. Surg Today, 2013, 43(4):456-460.
22. Hamdi M, Van Landuyt K, De Frene B, et al. The versatility of the inter-costal artery perforator (ICAP) flaps. J Plast Reconstr Aesthet Surg, 2006, 59(6):644-652.
23. Kalender V, Aydm H, Karabulut AB, et al. Breast reconstruction with the internal mammary artery pedicled fasciocutaneous island flap:description of anew flap. Plast Reconstr Surg, 2000, 106(7):1494-1498.
24. Maillard GF. Breast reconstruction with the internal mammary artery pedicled fasciocutaneous island flap:description of a new flap. Plast Reconstr Surg, 2002, 109(3):1203-1204.
25. Kim J, Yoo J, Lee J, et al. Oncoplastic reconstruction with superior based lateral breast rotation flap after lower quadrant tumor resection. J Breast Cancer, 2012, 15(3):350-355.
26. Nahabedian MY. Achieving ideal breast aesthetics with autologous reconstruction. Gland Surg, 2015, 4(2):134-144.
27. Clough KB, Kaufman GJ, Nos C, et al. Improving breast cancer surgery:a classification and quadrant per quadrant Atlas for oncoplastic surgery. Ann Surg Oncol, 2010, 17(5):1375-1391.
28. Fujishiro S, Mitsumori M, Kokubo M, et al. Cosmetic results and complications after breast conserving therapy for early breast cancer. Breast Cancer, 2000, 7(1):57-63.
29. Vrieling C, Collette L, Fourquet A, et al; EORTC Radiotherapy and Breast Cancer Cooperative Groups. The influence of patient, tumor and treatment factors on the cosmetic results after breastconserving therapy in the EORTC 'boost vs. no boost' trial. Radiother Oncol, 2000, 55(3):219-232.
30. 朱江, 康骅, 海涛, 等.腔镜腋窝淋巴结清扫与传统腋窝淋巴结清扫对保乳手术美容效果影响的比较.中国微创外科杂志, 2014, 14(6):498-502.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of Adjacent Tissue Flap in Reconstruction of Breast Defect Following Breast Conserving Surgery for Early Breast Cancer

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