Local Fascio-Cutaneous Flaps for Skin Cover after Large Mastectomies for Locally Advanced Breast Cancer – An Indian Perspective

Local Fascio-Cutaneous Flaps for Skin Cover after Large Mastectomies

Abstract

Background: Many patients in India still present with locally-extensive breast cancer to the general surgeon. Surgical ablation for such tumours results in large chest wall defects management of which becomes difficult in absence of surgical oncologist- plastic surgeon team as is the case in large parts of the country. The purpose of this article is to present simple local fascio-cutaneous flaps which can be done by general surgeons. Subjects and Methods: Among 8 local flaps, 5 were laterally based thoraco-abdominal (TA) flaps, and 3 were medially based thoraco-epigastric (TE) flaps. Clinical outcomes were compared including complications, the need for a secondary surgical intervention, and the timing of adjuvant therapy. Results: The mean defect size was 410.6 cm2 (range, 140720 cm2). One case of wound dehiscence (12.5%) was noted in the lateral based (TE) flap group. All patients survived more than 1 year without any local recurrence or delay in adjuvant treatment. Conclusion: Local fascio-cutaneous flaps are a viable option to treat large chest wall defects after the excision of locally advanced breast cancer. They are simple, robust and can be performed easily by general surgeons.