28Mar 2018

AN ONCOPLASTIC APPROACH USING INFRAMAMMARY TRANSPOSITION FLAP TO REPLACE PARTIAL MASTECTOMY DEFECTS.

  • Surgery, Medical Research Institute, Alexandria University, Alexandria, Egypt.
  • Anatomy And Embryology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
  • Abstract
  • Keywords
  • References
  • Cite This Article as
  • Corresponding Author

Introduction: resection of inferior breast tumors may result in substantial deformity. Inframammary tongue shaped adipofascial flaps (AFPs) were proposed to reconstruct inferior defects but the vascularity of these flaps are not certain. Anatomical studies in our institution favored medial and lateral vascular routes to superiorly based flaps. Aim of the work: to evaluate the safety and adequacy of inframammary transposition flaps (IMTFs) based on medial and lateral vascular roots to reconstruct defects in the inferior breast following breast conservative surgery. Patients and methods: Ten patients with small to moderate breast sizes and inferior tumors under went wide resection to negative margins through an inframammary line (IML) incision. The excess tissues below the IML were used as transposition flaps medially or laterally based (according to tumor position). These flaps were moved into breast superiorly to replace defects. The rate of complications and esthetic outcomes were presented. Results: low rates of fat necrosis and other complications coupled with excellent esthetic results were obtained. Conclusions: IMTFs are safe and reliable means of oncoplastic breast surgery with accepted complications and satisfaction rates.


  1. Franceschini, G., Sanchez, A. M., Di Leone, A., Magno, S., Moschella, F., Accetta, C., & Masetti, R. (2015). New trends in breast cancer surgery: a therapeutic approach increasingly efficacy and respectful of the patient. Il Giornale Di Chirurgia, 36(4), 145?152. http://doi.org/10.11138/gchir/2015.36.4.145
  2. Piper, M., Peled, A. W., & Sbitany, H. (2015). Oncoplastic breast surgery: current strategies. Gland Surgery, 4(2), 154?163. http://doi.org/10.3978/j.issn.2227-684X.2015.03.01
  3. Macmillan, R. D., & McCulley, S. J. (2016). Oncoplastic Breast Surgery: What, When and for Whom? Current Breast Cancer Reports, 8, 112?117. http://doi.org/10.1007/s12609-016-0212-9
  4. Piper, M., Peled, A. W., & Sbitany, H. (2015). Oncoplastic breast surgery: current strategies. Gland Surgery, 4(2), 154?163. http://doi.org/10.3978/j.issn.2227-684X.2015.03.01
  5. Munhoz, A. M., Montag, E., & Gemperli, R. (2013). Oncoplastic breast surgery: indications, techniques and perspectives. Gland Surgery, 2(3), 143?157. http://doi.org/10.3978/j.issn.2227-684X.2013.08.02
  6. Immediate reconstruction using inframammary adipofascial flap of the anterior rectus sheath after partial mastectomy.
  7. Yuko Kijima, Heiji Yoshinaka, Tetsuhiro Owaki, Yawara Funasako, Takashi Aikou. Am J Surg. 2007 Jun; 193(6): 789?791. doi: 10.1016/j.amjsurg.2006.06.052
  8. Yang, J. D., Lee, J. W., Cho, Y. K., Kim, W. W., Hwang, S. O., Jung, J. H., & Park, H. Y. (2012). Surgical Techniques for Personalized Oncoplastic Surgery in Breast Cancer Patients with Small- to Moderate-Sized Breasts (Part 2): Volume Replacement. Journal of Breast Cancer, 15(1), 7?14. http://doi.org/10.4048/jbc.2012.15.1.7
  9. Peeters, B. Cambier, T. Stasch, and S. Grandel, ?The exposed breast prosthesis at the infra-mammary region: treatment by local flaps,? European Journal of Plastic Surgery, vol. 34, no. 6, pp. 513?516, 2011.
  10. Ehab M. Elzawawy, Melad N. Kelada, and Ahmed F. Al Karmouty, ?New Possible Surgical Approaches for the Submammary Adipofascial Flap Based on Its Arterial Supply,? Anatomy Research International, vol. 2016, Article ID 7696010, 10 pages, 2016. doi:10.1155/2016/7696010
  11. Ogawa T, Hanamura N, Yamashita M, Ri Y, Kuriyama N, Isaji S. Usefulness of breast-volume replacement using an inframammary adipofascial flap after breast-conservation therapy. Am J Surg. 2007 Apr;193(4):514-8
  12. Kijima, H. Yoshinaka, M. Hirata, A. Nakajo, H. Arima, S. Ishigami, S. Ueno and S. Natsugoe, "Histological Findings of a Local Adipofascial Flap That Was Implanted during Breast Conserving Surgery," Modern Plastic Surgery, Vol. 3 No. 1, 2013, pp. 43-46. doi: 10.4236/mps.2013.31008.
  13. Adil Aljarrah, Claude Nos, Rana Nasr, Krishna B. Clough, Anne-Sophie Bats, Fabrice Lecuru. Updated follow-up of patients treated with the oncoplastic ?Crescent? technique for breast cancer. The Breast , Volume 21 , Issue 4 , 475 ? 479
  14. Bjelic-Radisic. Tumor quadrantectomy and defect remodeling with an epigastric skin flap. In Springer Verlag Vienna 2015: F. Fitzel, P. Schrenk(eds.). oncoplastic breast surgery: a guide to clinical practice. Second edition, capter11; 43-44.

[Ahmed F. Al Karmouty, Ahmed E. Shaaban, Ehab M. Elzawawy and Melad N. Kelada. (2018); AN ONCOPLASTIC APPROACH USING INFRAMAMMARY TRANSPOSITION FLAP TO REPLACE PARTIAL MASTECTOMY DEFECTS. Int. J. of Adv. Res. 6 (Mar). 1398-1403] (ISSN 2320-5407). www.journalijar.com


ahmad farouk al karmouty
1Surgery, Medical Research Institute, Alexandria University, Alexandria, Egypt.

DOI:


Article DOI: 10.21474/IJAR01/6811      
DOI URL: https://dx.doi.org/10.21474/IJAR01/6811