Oncoplastic Breast Surgery for Breast Cancer Located in the Outer Site of the Breast

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  • 乳房外側領域癌に対するOncoplastic Surgery
  • - Pedicled adipose flap and advancement flap -
  • ―有茎脂肪弁と前進皮弁―

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<p>Oncoplastic breast surgery using a lateral tissue flap (LTF) improves the postoperative cosmetic outcome in breast cancer patients in whom the tumor is located on the outer site of the breast. However, partial reconstruction with LTF is difficult in skinny patients with no available lateral thoracic artery and vein (LTAV) as a pedicle. Therefore, we present another volume replacement technique, namely, a lateral advancement flap (LAF) . The LAF procedure is as follows: after partial mastectomy, subcutaneous fat tissue is removed from the anterior serratus, and used to replace the breast tissue and skin defects. Mobility and volume are lower for LTF, but the surgical procedure is simpler for LAF than for LTF. The LAF has abundant blood supply; thus, there is no risk of fat necrosis. Furthermore, it can supply both skin and fat tissue, which means that it can prevent skin tension and nipple dislocation caused by sutures in cases of skin loss. Therefore, for cases without skin loss, and an available LTAV and thick subcutaneous fat tissue, we perform partial reconstruction with LTF. On the contrary, we perform volume replacement using LAF for skinny patients with skin loss or no available LTAV. It may be important to use the two different techniques to improve the outcome.</p>

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