Article Abstract

The impact of partial breast reconstruction with lateral chest wall perforator flaps on post-operative cancer surveillance

Authors: Jesse Hu, Alexandra Tenovici, Vaishali Parulekar, Madhu Bhattacharyya, Pankaj G. Roy


Background: Partial breast reconstruction (PBR) with chest wall perforator flaps (CWPFs) has extended the indications for breast conserving surgery (BCS) for women with breast cancer. As this is a relatively new technique, there is paucity of literature reporting the effects on surveillance mammograms. The aim of this paper is to characterize the mammographic findings of post BCS breast after CWPF and evaluate the outcomes and impact on surveillance mammograms.
Methods: This is a retrospective analysis of a prospectively maintained database on all patients who underwent PBR with CWPF as part of BCS by a single surgeon. Mammograms done after surgery were reviewed and analysed for characteristic qualitative features and the need for additional imaging and/or biopsy.
Results: Sixty-four women diagnosed with breast cancer underwent PBR over the study period (Aug 2011–Apr 2016). The median age at diagnosis was 50 years (range: 34–69 years) and 29.7% (19/64) were screen-detected. The median follow-up was 2 years (range: 1–5 years). Six patients were excluded as 4 subsequently underwent completion mastectomy, 1 refused mammographic surveillance and 1 had yet to have their first surveillance mammogram. A total of 58 patients who had at least one surveillance mammogram were included. In total, 134 mammograms were reviewed, of which 2.2% (3/134) required additional imaging and all required biopsy. The biopsy results were benign lesions (n=2) fat necrosis and 1 had benign calcifications with atypia.
Conclusions: Surveillance mammographic follow-up after PBR with CWPF in women undergoing BCS for breast cancer is accurate with low recall & biopsy rates.