6533b830fe1ef96bd129664f

RESEARCH PRODUCT

Nipple-sparing mastectomy and breast reconstruction with a deep inferior epigastric perforator flap using thoracodorsal recipient vessels and a low lateral incision

Olivia A. HoMing-huei ChengMarco PappalardoYi-ling Lin

subject

Nipple-Sparing MastectomyAdultmedicine.medical_specialtymedicine.medical_treatmentMammaplastyBreast Neoplasms030230 surgeryFree Tissue Flaps03 medical and health sciencesYoung Adult0302 clinical medicineAbdominal flapsThoracic Arteriesbreast reconstruction deep inferior epigastric perforator internal mammary vessels quality of life thoracodorsal vesselsmedicineHumansMammary ArteriesMastectomyAgedbreast reconstruction; deep inferior epigastric perforator; internal mammary vessels; quality of life; thoracodorsal vessels; Adult; Aged; Anastomosis Surgical; Breast Neoplasms; Epigastric Arteries; Female; Follow-Up Studies; Free Tissue Flaps; Humans; Mammaplasty; Mammary Arteries; Mastectomy; Middle Aged; Nipples; Organ Sparing Treatments; Perforator Flap; Prognosis; Quality of Life; Thoracic Arteries; Young Adultbusiness.industryAnastomosis SurgicalCosmesisGeneral MedicineMiddle AgedPrognosisEpigastric ArteriesSurgerymedicine.anatomical_structureOncology030220 oncology & carcinogenesisNipplesMammaplastyQuality of LifeSurgeryFemalebusinessComplicationBreast reconstructionOrgan Sparing TreatmentsPerforator FlapMastectomyArteryFollow-Up Studies

description

Background Nipple-sparing mastectomy poses challenges in providing esthetically-pleasing immediate autologous breast reconstruction. This study was to investigate the outcomes of nipple-sparing mastectomy with breast reconstruction using free abdominal flaps between two different recipient sites. Methods Between 2010 and 2016, 79 patients who underwent nipple-sparing mastectomy with autologous breast reconstruction using thoracodorsal (TD) vessels in 30 cases or internal mammary (IM) vessels in 49 cases were investigated. Demographics, intraoperative findings, complications, and quality of life using Breast-Q questionnaire were compared between two groups. Results All flap survived. There was no statistical difference in age, BMI, ischemia time, and flap-used percentage. The TD artery had a statistically smaller diameter 1.8 ± 0.4 mm than the IM artery 2.7 ± 0.43 mm (p = 0.02). At a mean follow-up of 44.4 ± 35.2 months, there was no statistical difference in total complication rates between TD and IM groups (23.3% and 36.7%, respectively, p > 0.05). The "psychosocial well-being" of Breast-Q in TD group 83.9 ± 14.6 was statistically greater than IM group 72.8 ± 17.6 (p = 0.04). Conclusions Nipple-sparing mastectomy with immediate breast reconstruction using TD vessels with a low lateral scar is a safe procedure that provides an inconspicuous scar with better cosmesis and minimal complication rate.

yearjournalcountryeditionlanguage
2018-01-01
10.1002/jso.25204https://hdl.handle.net/11380/1200899