Two modified surgical procedures for treating early stage breast cancer in China

Abstract

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 “total tumor free”, whilst fit into the unique characteristics of China’s own medical system as well as patients’ 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 conserving 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 protuberance 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 varied 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 practical, and aesthetically satisfactory, with high applicability in China. They do not compromise the oncological outcomes, but also are well-accepted by Chinese patients.

Keywords

early breast cancer / breast conserving surgery / modified transverse rectus abdominis myocutaneous flap reconstruction

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