Comparative study between the latissimus dorsi flap and thoracoabdominal flap in the coverage of skin defects after mastectomy for advanced and recurrent breast cancer

Asal, Mohamed F.; Nagi, Ahmed; Barakat, Khaled E.; Ewedah, Moataz; Abdullatif, Ahmed

doi:10.4103/ejs.ejs_220_22

Comparative study between the latissimus dorsi flap and thoracoabdominal flap in the coverage of skin defects after mastectomy for advanced and recurrent breast cancer

Authors

Abstract

Background
Breast cancer is the most common cancer among women, accounting for ~26% of all incident cancers. Modified radical mastectomy is still one of the most commonly used surgical techniques for breast cancer, and in some selected patient it is the only surgery to be performed. Skin defects after mastectomy is a major problem facing breast surgeons, especially in cases of recurrent breast cancer, locally advanced breast cancer as in the case of inflammatory breast cancer as well as male breast cancer.
Aim
The present study compares the thoracoabdominal flap and the latissimus dorsi flap in the coverage of skin defects after mastectomy.
Materials and methods
The present study was conducted on 60 patients with recurrent, locally advanced female breast cancer and male breast cancer after receiving neoadjuvant chemotherapy, who were candidates for modified radical mastectomy that resulted in chest wall defect and needed skin coverage. Patients were admitted to the Surgical Oncology Unit, Alexandria Main University Hospital. Patients were randomly classified into two equal groups, of 30 patients each.
Result
Patients were randomly classified into two equal groups. Group A had modified radical mastectomy with coverage of defect using the latissimus dorsi flap. Group B had modified radical mastectomy with coverage of defects using the thoracoabdominal flap, and there was no significant difference between the two groups in terms of age, size of breast, site of lesion, neoadjuvant treatment, size of mass, contraceptive pills, and size of the defect. A statistical significance between two groups were found in the size of the harvested flaps (<0.001) and the duration of the operation (<0.001).
Conclusion
Chest wall defects following mastectomy can be covered by use of the latissimus dorsi flap or the thoracoabdominal flap. The advantages of thoracoabdominal flaps over latissimus dorsi flaps is the size of the harvested flap size and duration of operation as well as it is more applicable in Egyptian females with a large belly skin and heavily infiltrated axilla in locally advanced breast cancer (LABC).

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