Chest Wall–Based Flap for Repairing Partial Mastectomy Defects

Objective The objective of this study is to introduce a single and reproducible tissue-rearrangement oncoplastic technique that is applicable for all quadrants partial-mastectomy defects in small- to medium-sized breasts, using grounds drawn from cosmetic surgery. Methods Eleven small- to medium-sized breast cancer patients with tumor involvement of more than a quarter of the breast were operated on using the chest wall-based flap technique. The procedure is described in detail, and the results are analyzed in terms of both cosmetic and oncological results. Results The flap successfully reached all breast quadrants as necessary, as well as the areola-nipple complex. The resection borders were found to be free of tumor in all cases, and there were no perioperative complications. Patients rated nearly all the cosmetic parameters as "somewhat satisfied" or "very satisfied," and there was no evidence of fat necrosis in the postoperative mammography examinations. Conclusions Applying principles taken from the cosmetic plastic surgery lies at the base of any high standard reconstructive surgery in general and oncoplastic breast surgery in particular. The chest wall-based flap is suitable for the reconstruction of a wide range of breast lumpectomy defects and is feasible for small- to medium-sized breasts, which are usually not easily amenable to tissue rearrangement techniques. The learning curve is short, with replicable results.