Postoperative Cancer Surveillance Following Oncoplastic Surgery with Latissimus Dorsi Flap: a Matched Case-Control Study.

Postoperative Cancer Surveillance Following Oncoplastic Surgery with Latissimus Dorsi Flap: a Matched Case-Control Study. - 2019

Available online from MWHC library: 1994 - present

BACKGROUND: The latissimus dorsi (LD) myocutaneous flap is a widely used local option in oncoplastic surgery for avoiding breast deformities; however, concerns exist regarding its influence in monitoring recurrence. In this study, we evaluated the impact of this flap on postoperative cancer surveillance. CONCLUSION: Although there was an increase in benign calcifications in the oncoplastic group, there were no additional abnormal findings requiring further intervention. We concluded that the LD flap for oncoplastic surgery does not interfere with cancer surveillance, and even decreases the rate of fluid collection. METHODS: Each patient receiving oncoplastic surgery with LD flap after partial mastectomy were matched in age, cancer stage, and body mass index with patients receiving partial mastectomy alone. Twenty-nine patients with the oncoplastic LD flap received 99 mammograms and 139 ultrasonograms, while 29 patients with partial mastectomy alone underwent 92 mammograms and 129 ultrasonograms. Mammographic and ultrasonographic findings were classified by Breast Imaging Reporting and Data System (BI-RADS) category and reviewed. Any recommendations for additional evaluation and recurrence were documented. RESULTS: During an average follow-up period of 44 months, although the oncoplastic group demonstrated more newly developed benign calcifications (control 14% vs. oncoplastic 41%; p = 0.019) on mammography, the percentage of recall for additional imaging in category 0, and the short-interval follow-up in category 3, was not different between the control and oncoplastic group. Regarding ultrasonography, BI-RADS category was also not different between the two groups; however, the control group showed more fluid collections than the oncoplastic group (control 21% vs. oncoplastic 0%; p = 0.023). One case of local recurrence was observed in the control group.


English

1068-9265

10.1245/s10434-019-07898-4 [doi] 10.1245/s10434-019-07898-4 [pii]


*Breast Neoplasms/su [Surgery]
*Carcinoma, Ductal, Breast/su [Surgery]
*Carcinoma, Lobular/su [Surgery]
*Mammaplasty/mt [Methods]
*Neoplasm Recurrence, Local/di [Diagnosis]
*Surgical Flaps
Breast Neoplasms/pa [Pathology]
Carcinoma, Ductal, Breast/pa [Pathology]
Carcinoma, Lobular/pa [Pathology]
Case-Control Studies
Female
Follow-Up Studies
Humans
Incidence
Mammography
Mastectomy
Middle Aged
Neoplasm Recurrence, Local/ep [Epidemiology]
Population Surveillance
Postoperative Period
Prognosis
Republic of Korea/ep [Epidemiology]
Retrospective Studies
Superficial Back Muscles


MedStar Washington Hospital Center


Surgery/Plastic Surgery


Journal Article

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