ecancermedicalscience

Short Communication

Extreme oncoplasty for centrally located breast cancer in small non-ptotic breasts: extending the indications of chest wall perforator flaps with areolar reconstruction

1 Nov 2021
Shashank Nigam, Andrew Eichholz, Madhu Bhattacharyya, Vaishali Parulekar, Pankaj Gupta Roy

Background: Breast cancers located centrally require excision of nipple-areola complex. A simple central wide excision is a safe option but results in suboptimal aesthetic outcome. An oncoplastic option involves therapeutic mammoplasty with or without areolar reconstruction, limited to moderate and large ptotic breasts. For small non-ptotic breasts, most surgeons would resort to mastectomy with/without reconstruction.

Methods: Lateral chest wall perforator flap (CWPF) is an option for partial breast reconstruction in small to moderate sized, non-ptotic breasts for laterally located tumours. We have extended the application of CWPF for central tumours to avoid mastectomy in selected patients.

Results: We here present a case series of four patients with small to medium-sized non-ptotic breasts, who had centrally located breast cancer or ductal carcinoma in-situ (DCIS). Three patients had single stage CWPF reconstruction, and one had central excision with immediate reconstruction following a failed attempt at therapeutic mammoplasty. All had the areola reconstructed using flap skin; one patient had simultaneous nipple reconstruction.

Conclusions: CWPF is an option for treatment of centrally located breast cancers/DCIS needing nipple-areola complex excision for patients wishing to avoid mastectomy. Patients with small to medium-sized non-ptotic breasts are suitable, and need to be carefully selected.

Related Articles

Nithiya Sinarajoo, Yek-Ching Kong, Ranjit Kaur, Ros Suzanna Bustamam, Nur Fadhlina Abdul Satar, Sharminii Jaya-Prakason, Harenthri Devy Alagir Rajah, Mahmoud Danaee, Cheng-Har Yip, Nirmala Bhoo-Pathy
Lisa Ximena Rodríguez Rojas, Liliana Doza Martínez, Jorge Andrés Olave Rodríguez, Sandra Eliana Murillo Rusynke, Paola Andrea Pérez Castellano, David Alexander Bolaños Beltrán, Helen Johana Ortiz Rojas, José Antonio Nastasi Catanese