The Results of Surveillance Imaging After Breast Conservation Surgery and Partial Breast Reconstruction With Chest Wall Perforator Flaps; A Qualitative Analysis Compared With Standard Breast-Conserving Surgery for Breast Cancer

• Published in: Clinical breast cancer Vol. 19; no. 3; pp. e422 - e427
• Main Authors: Hu, Jesse, Cuffolo, Giulio, Parulekar, Vaishali, Chan, Victoria, Tenovici, Alexandra, Roy, Pankaj G.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2019
• Subjects: Breast reconstruction; Breast surgery; Oncoplastic; Surveillance mammogram; Volume replacement; Oncoplastic; Volume replacement; Surveillance mammogram; Breast reconstruction; Breast surgery
• ISSN: 1526-8209; 1938-0666
• DOI: 10.1016/j.clbc.2019.01.010

Partial breast reconstruction (PBR) using chest wall perforator flaps (CWPF) allows for excision of tumors in the outer quadrant of the breast in women with small to moderate non-ptotic breasts resulting in a good aesthetic outcome. There are limited data available in the literature regarding long-term follow-up and the effect of CWPF on subsequent surveillance mammographic interpretation and recall rates. A retrospective audit with qualitative analysis of initial mammograms was performed to assess this. This retrospective analysis of a prospectively maintained database included all consecutive patients who underwent either PBR with CWPF or wide local excision (WLE) between January 2013 and December 2014 by a single surgeon in a tertiary referral center. Qualitative analysis of the postoperative mammograms was performed after review by 2 blinded radiologists. Thirty-six patients were included in the study, 18 in each arm. The CWPF group was younger and had larger tumor size anticipated on preoperative imaging, which correlated with larger specimens excised. Both groups were comparable with respect to tumor pathological characteristics. Comparing the first postoperative mammograms, both groups were similar in features reported such as calcifications, fat necrosis, volume loss, and radiotherapy changes. During the follow-up period (median 4 years), 138 surveillance mammograms were performed. One patient was recalled for further imaging in the CWPF group. There was no significant difference in the need for diagnostic imaging and biopsy between the groups. Patients who underwent PBR using CWPF had similar features on postoperative surveillance mammograms compared with that post WLE. There are few published data on mammographic surveillance after partial breast reconstruction using chest wall perforator flaps (CWPF). In this study we compared 36 patients who underwent breast conservation surgery with CWPF or standard wide local excision. Over a median 4-year follow up, 138 surveillance mammograms demonstrated no significant difference in mammographic features between the 2 groups. Only 1 CWPF patient was recalled for further imaging.