Oncoplastic partial breast reconstruction using volume replacement techniques

Abstract

Abstract Objective This study evaluates the surgical, oncologic and aesthetic outcomes of oncoplastic partial breast reconstruction (PBR) using volume replacement (VR) by different perforator flaps for the treatment of operable breast cancer (BC). Methods This prospective, observational study enrolled 32 female patients undergoing oncoplastic breast‐conserving surgery (OBCS) with immediate PBR using either a lateral intercostal artery perforator (LICAP) flap, lateral thoracic artery perforator (LTAP) flap or anterior intercostal artery perforator (AICAP) flap. Assessments of surgical and oncologic outcomes, including clear margin rates, re‐operation rates and complication profiles, were conducted. Aesthetic outcomes were evaluated using a modified scale based on the aesthetic items scale (AIS) and patient‐reported outcome measures (PROMs). Results Clear surgical margins were achieved in 100% of cases ( n = 32), with a 0% post‐operative re‐excision rate. The mean operative time was 130.28 ± 8.12 min, and the mean resected weight was 186.97 ± 34.91 g. Overall complication rate was 21.9% ( n = 7), with no cases of complete flap loss. Aesthetic outcomes were highly favourable, with a mean total AIS score of 23 (±2.4) out of 25. Patient satisfaction was high, with 87.5% ( n = 28) reporting scores of 4/5 out of 5. There was no need for any contralateral symmetrization procedures. Neither local recurrence nor distant metastasis was detected during the follow‐up period (median, 16.5 months). Conclusion Oncoplastic PBR using chest wall perforator flaps is a safe and effective VR method to achieve good oncologic and aesthetic results in BC patients with small‐to‐medium breasts.