Anterior intercostal artery perforator flap as a method of reconstruction of lower pole defects in patients with breast cancer: Ain Shams University Hospital experience

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Abstract

Background
Surgical management of breast cancer has shown considerable evolution in the past few decades. Conservative breast surgery has become an accepted option to radical procedures as a consequence of its equivalent overall survival rate with a better quality of life. The use of Doppler for perforator vessel localization allows the use of anterior intercostal perforator (AICAP) flap as a volume-replacement option in breast-conserving surgery in small-sized and medium-sized breasts for lower pole lesions.
Aim
To evaluate the feasibility and outcome of AICAP flap as a volume-replacement technique in breast-conservative surgery in Egypt.
Patients and methods
This was a prospective study carried out at Ain Shams University hospitals that included 40 patients with early-stage breast cancers who underwent breast-conservative mastectomies between November 2018 and November 2021.
Results
The mean operative time was 64 min. Overall, two cases with complications were reported with fat necrosis and mild wound infection, which were managed conservatively. No flap loss occurred, and all patients were satisfied with the cosmetic outcome.
Conclusion
The AICAP flap is a safe and cost-effective method as a volume-replacement breast conservative surgery with excellent outcomes for small-sized and medium-sized beast, with a large-volume resection giving high satisfaction rate and minimal morbidity, and it is an acceptable option for lower pole breast lesion in a large breast size if the patient refuses reduction and contralateral symmetrization.

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