Climbing the Learning Curve with Chest Wall Perforator flaps
Association of Breast Surgery ePoster Library. Williams S. 05/13/19; 257159; P116
Samantha Williams
REGULAR CONTENT
Login now to access Regular content available to all registered users.
Abstract
Discussion Forum (0)
Rate & Comment (0)
P116
Topic: Oncoplastic and aesthetic surgery
Introduction: Chest wall perforator flaps (CWPF) are increasing in popularity to avoid mastectomy in patients with a large tumour to breast ratio and give superior cosmesis to breast conserving surgery (BCS) alone. We report our experience of introducing CWPF.Method: Analysis of a consecutive series of CWPFs from a prospectively maintained database. All operations were performed by a single surgeon, who is now supervising surgeons in the unit and other centres. All were added to the UK National Flap Registry. Results: Since 2016, 32 patients underwent CWPF surgery (14 LTAP, 13 LICAP, 3 combined, 3 AICAP, 1 MICAP). Four were two-staged, 28 were immediate. Median age 53 years (32-70), median cup size was a C (AA-G), mean BMI 24.8 kg/m2 (19.3-32.1). Mean pre-operative tumour size was 34mm (13 -65mm) and mean specimen weight was 107.8g (14-282g). Median operative time was 2 hours, 47 minutes. Seven patients (21.8%) underwent re-excision; none had to be converted to mastectomy. Complications included 1 haematoma, requiring re-operation, and 1 wound infection, requiring intravenous antibiotics, no flap loss has been reported.Conclusion: CWPF has been successfully introduced, with good cosmetic outcomes and a low complication rate. This has extended our ability to perform BCS without causing deformity. Re-excision rates were similar to ABS guidelines (20% re-excision rate). The higher than expected re-excision rate was caused by radiological under-estimation of DCIS in 4 of the 7 patients. They all underwent successful re-excision whilst maintaining the CWPF. With increasing experience, operative times have reduced and indications have expanded.
Topic: Oncoplastic and aesthetic surgery
Introduction: Chest wall perforator flaps (CWPF) are increasing in popularity to avoid mastectomy in patients with a large tumour to breast ratio and give superior cosmesis to breast conserving surgery (BCS) alone. We report our experience of introducing CWPF.Method: Analysis of a consecutive series of CWPFs from a prospectively maintained database. All operations were performed by a single surgeon, who is now supervising surgeons in the unit and other centres. All were added to the UK National Flap Registry. Results: Since 2016, 32 patients underwent CWPF surgery (14 LTAP, 13 LICAP, 3 combined, 3 AICAP, 1 MICAP). Four were two-staged, 28 were immediate. Median age 53 years (32-70), median cup size was a C (AA-G), mean BMI 24.8 kg/m2 (19.3-32.1). Mean pre-operative tumour size was 34mm (13 -65mm) and mean specimen weight was 107.8g (14-282g). Median operative time was 2 hours, 47 minutes. Seven patients (21.8%) underwent re-excision; none had to be converted to mastectomy. Complications included 1 haematoma, requiring re-operation, and 1 wound infection, requiring intravenous antibiotics, no flap loss has been reported.Conclusion: CWPF has been successfully introduced, with good cosmetic outcomes and a low complication rate. This has extended our ability to perform BCS without causing deformity. Re-excision rates were similar to ABS guidelines (20% re-excision rate). The higher than expected re-excision rate was caused by radiological under-estimation of DCIS in 4 of the 7 patients. They all underwent successful re-excision whilst maintaining the CWPF. With increasing experience, operative times have reduced and indications have expanded.
P116
Topic: Oncoplastic and aesthetic surgery
Introduction: Chest wall perforator flaps (CWPF) are increasing in popularity to avoid mastectomy in patients with a large tumour to breast ratio and give superior cosmesis to breast conserving surgery (BCS) alone. We report our experience of introducing CWPF.Method: Analysis of a consecutive series of CWPFs from a prospectively maintained database. All operations were performed by a single surgeon, who is now supervising surgeons in the unit and other centres. All were added to the UK National Flap Registry. Results: Since 2016, 32 patients underwent CWPF surgery (14 LTAP, 13 LICAP, 3 combined, 3 AICAP, 1 MICAP). Four were two-staged, 28 were immediate. Median age 53 years (32-70), median cup size was a C (AA-G), mean BMI 24.8 kg/m2 (19.3-32.1). Mean pre-operative tumour size was 34mm (13 -65mm) and mean specimen weight was 107.8g (14-282g). Median operative time was 2 hours, 47 minutes. Seven patients (21.8%) underwent re-excision; none had to be converted to mastectomy. Complications included 1 haematoma, requiring re-operation, and 1 wound infection, requiring intravenous antibiotics, no flap loss has been reported.Conclusion: CWPF has been successfully introduced, with good cosmetic outcomes and a low complication rate. This has extended our ability to perform BCS without causing deformity. Re-excision rates were similar to ABS guidelines (20% re-excision rate). The higher than expected re-excision rate was caused by radiological under-estimation of DCIS in 4 of the 7 patients. They all underwent successful re-excision whilst maintaining the CWPF. With increasing experience, operative times have reduced and indications have expanded.
Topic: Oncoplastic and aesthetic surgery
Introduction: Chest wall perforator flaps (CWPF) are increasing in popularity to avoid mastectomy in patients with a large tumour to breast ratio and give superior cosmesis to breast conserving surgery (BCS) alone. We report our experience of introducing CWPF.Method: Analysis of a consecutive series of CWPFs from a prospectively maintained database. All operations were performed by a single surgeon, who is now supervising surgeons in the unit and other centres. All were added to the UK National Flap Registry. Results: Since 2016, 32 patients underwent CWPF surgery (14 LTAP, 13 LICAP, 3 combined, 3 AICAP, 1 MICAP). Four were two-staged, 28 were immediate. Median age 53 years (32-70), median cup size was a C (AA-G), mean BMI 24.8 kg/m2 (19.3-32.1). Mean pre-operative tumour size was 34mm (13 -65mm) and mean specimen weight was 107.8g (14-282g). Median operative time was 2 hours, 47 minutes. Seven patients (21.8%) underwent re-excision; none had to be converted to mastectomy. Complications included 1 haematoma, requiring re-operation, and 1 wound infection, requiring intravenous antibiotics, no flap loss has been reported.Conclusion: CWPF has been successfully introduced, with good cosmetic outcomes and a low complication rate. This has extended our ability to perform BCS without causing deformity. Re-excision rates were similar to ABS guidelines (20% re-excision rate). The higher than expected re-excision rate was caused by radiological under-estimation of DCIS in 4 of the 7 patients. They all underwent successful re-excision whilst maintaining the CWPF. With increasing experience, operative times have reduced and indications have expanded.
Code of conduct/disclaimer available in General Terms & Conditions
{{ help_message }}
{{filter}}