We report a patient with breast cancer whose breast was immediately reconstructed using a local adipofascial flap and was then subsequently resected 3 years after the original surgical procedure due to local recurrenc...We report a patient with breast cancer whose breast was immediately reconstructed using a local adipofascial flap and was then subsequently resected 3 years after the original surgical procedure due to local recurrence. In order to achieve local control of the solitary recurrent lesion, we resected the remnant breast, which gave us a useful opportunity to examine the previously implanted flap histologically. A 33-year-old Japanese female was diagnosed with T2N0M0 breast cancer in the outer area of her left breast and underwent partial mastectomy with immediate reconstruction using a local adipofascial flap. The breast lesion was considered to be invasive ductal carcinoma, scirrhous carcinoma, lymphatic invasion+, venous invasion-, estrogen receptor+, progesterone receptor+, and HER2/neu-. Involvement was noted in three of the twenty-five resected axillary lymph nodes. She received adjuvant hormone therapy, but developed a solitary local recurrence of the skin forty-five months after the initial procedure, for which she received total mastectomy, systemic chemotherapy, and hormone therapy. During the histological examination of the local adipofascial flap that had been implanted into the partial breast defect, normal fatty tissue and the implanted fascia were seen at the implantation site. This is a rare report in which a local flap that was implanted during oncoplastic breast surgery was histologically examined.展开更多
Conventional pedicled-flap based surgeries in treating breast cancer have their limitations. New surgical regimens are yet to be explored, which will follow the oncological principle of being “to- tal tumor free”, w...Conventional pedicled-flap based surgeries in treating breast cancer have their limitations. New surgical regimens are yet to be explored, which will follow the oncological principle of being “to- tal tumor free”, whilst fit into the unique characteristics of China＇s own medical system as well as pa- tients＇ demand. From 2007 to 2013, 143 patients with early stage breast cancer were included in the study, with the average age of 46.1 years. Fifty-three patients were subjected to modified breast con- serving surgery （MBCS）＋latissimus dorsi （LD） flap reconstruction, 41 to skin sparing mastectomy （SSM）＋implant＋LD flap reconstruction, 29 to MBCS＋distal transverse rectus abdominis myocutaneous （DTRAM） flap reconstruction, and 20 to SSM＋DTRAM flap reconstruction. The results showed that out of the 143 patients, there was no graft loss. Minor complications included 4 cases of fat liquefaction, and 6 cases of seratoma, which all resolved after conservative treatment. Five patients had visible protu- berance in the abdomen, but not leading to any gastrointestinal symptoms. The reconstructed breasts all presented good shape. 96.7% of the patients were satisfied with the outcome. The follow-up period var- ied from 6 months to 60 months, and only one patient died from tumor metastasis in the brain. No local recurrence occurred. It was concluded that these two modified pedicled-flap surgeries are readily practi- cal, and aesthetically satisfactory, with high applicability in China. They do not compromise the on- cological outcomes, but also are well-accepted by Chinese patients.展开更多
文摘We report a patient with breast cancer whose breast was immediately reconstructed using a local adipofascial flap and was then subsequently resected 3 years after the original surgical procedure due to local recurrence. In order to achieve local control of the solitary recurrent lesion, we resected the remnant breast, which gave us a useful opportunity to examine the previously implanted flap histologically. A 33-year-old Japanese female was diagnosed with T2N0M0 breast cancer in the outer area of her left breast and underwent partial mastectomy with immediate reconstruction using a local adipofascial flap. The breast lesion was considered to be invasive ductal carcinoma, scirrhous carcinoma, lymphatic invasion+, venous invasion-, estrogen receptor+, progesterone receptor+, and HER2/neu-. Involvement was noted in three of the twenty-five resected axillary lymph nodes. She received adjuvant hormone therapy, but developed a solitary local recurrence of the skin forty-five months after the initial procedure, for which she received total mastectomy, systemic chemotherapy, and hormone therapy. During the histological examination of the local adipofascial flap that had been implanted into the partial breast defect, normal fatty tissue and the implanted fascia were seen at the implantation site. This is a rare report in which a local flap that was implanted during oncoplastic breast surgery was histologically examined.
文摘Conventional pedicled-flap based surgeries in treating breast cancer have their limitations. New surgical regimens are yet to be explored, which will follow the oncological principle of being “to- tal tumor free”, whilst fit into the unique characteristics of China＇s own medical system as well as pa- tients＇ demand. From 2007 to 2013, 143 patients with early stage breast cancer were included in the study, with the average age of 46.1 years. Fifty-three patients were subjected to modified breast con- serving surgery （MBCS）＋latissimus dorsi （LD） flap reconstruction, 41 to skin sparing mastectomy （SSM）＋implant＋LD flap reconstruction, 29 to MBCS＋distal transverse rectus abdominis myocutaneous （DTRAM） flap reconstruction, and 20 to SSM＋DTRAM flap reconstruction. The results showed that out of the 143 patients, there was no graft loss. Minor complications included 4 cases of fat liquefaction, and 6 cases of seratoma, which all resolved after conservative treatment. Five patients had visible protu- berance in the abdomen, but not leading to any gastrointestinal symptoms. The reconstructed breasts all presented good shape. 96.7% of the patients were satisfied with the outcome. The follow-up period var- ied from 6 months to 60 months, and only one patient died from tumor metastasis in the brain. No local recurrence occurred. It was concluded that these two modified pedicled-flap surgeries are readily practi- cal, and aesthetically satisfactory, with high applicability in China. They do not compromise the on- cological outcomes, but also are well-accepted by Chinese patients.
