Oncoplastic immediate reconstruction using lateral thoracic wall perforator flaps after breast-conserving surgery: a prospective study of the oncological safety and cosmetic outcomes

Background
Breast-conserving therapy comprising wide local excision and postoperative irradiation is now believed to be an established technique in managing breast cancer. Breast-conserving therapy is now replacing mastectomy with equivalent survival. Lateral intercostal artery perforator flaps are innovative volume replacement techniques that expand the role of breast-conserving therapy, particularly in small-sized to medium-sized breasts with better aesthetic results. In our study, we aimed to evaluate the results of those flaps for immediate reconstruction of breast defects.
Patients and methods
This study included 40 patients who underwent wide local excision with immediate reconstruction using lateral thoracic wall perforator flaps in the period from June 2018 to June 2021. The operative duration, technique and modification of flap design, and postoperative complications were recorded. The cosmetic outcome and patient satisfaction were assessed. Follow-up was at least 1 year.
Results
Lateral intercostal artery perforator flap technique was performed in 40 patients. The mean operative time was 148±13.6 min. The flap length ranged from 11 to 15 cm and its width from 5 to 9 cm. Postoperative complications were seen in 10% of cases. Local recurrence occurred in 5% of cases. The average cosmetic assessment was observed to be either excellent or good in 95%.
Conclusions
Lateral thoracic wall perforator flaps are reliable and oncologically safe reconstructive procedures in laterally located breast cancers. The technique is simple and easy to learn. The modifications in the technique shorten the operative time and minimize the donor site complications. The postoperative complications are low. The overall cosmetic results and patient satisfaction are satisfactory.