The Use of Latissimus Dorsi Mini-Flap in Partial Breast Reconstruction

Author(s): Maher H. Ibraheem, Mina MG Youssef, Youhanna Abdalla, Rimoun Boutrus, Amr Farouk, Ahmed Morsi

Introduction: The cosmetic drawbacks of breast conserving surgery are asymmetry, nipple or skin retraction, and volume loss with unsatisfactory cosmetic outcome. The principle of Latissimus dorsi mini-flap (LDMF) is to use part of the Latissimus dorsi (LD) muscle as volume replacement to large breast defect up to 20 -30 % of the breast volume.

Purpose: To evaluate (LDMF) as a volume replacement to large breast defect after wide local excision in different breast quadrants and the benefit of using this procedure regarding the cosmetic outcomes, patient satisfaction, procedure-related complications.

Materials and Methods: The study was carried out at the National Cancer Institute, Cairo University, Egypt, from September 2017 to December 2018. Fifteen patients were selected. Wide local excision with post-resection defects of 20%-30% of breast volume were done. An inferolateral incision was done for both tumor resection and LDMF harvesting without any back scar. The patients were scheduled for regular follow up.

Results: All the resection margins were negative. Mean Operative time was 176.6 minutes, the mean hospital stay was 2.47 days. The mean score for sensory preservation was 7.66. The mean of visual analogue score VAS was 8.33 with a score range from 8 to 9. The mean of the surgeon evaluation was 8.53. The median ranged from 8 to 9.

Conclusion: LDMF makes BCS possible to a group of patients who are classically required mastectomy. It is particularly benefical to patients that responds poorly to neoadjuvant chemotherapy or with wide spreading DCIS.