Local flaps for partial breast reconstruction

Abstract

INTRODUCTION: Breast-conserving surgery (BCS) is often the first-line treatment for early-stage invasive breast cancer. Many studies claim that survival is non-inferior to radical treatments in selected cases. Although BCS preserves some breast tissue and often the nipple-areola complex, asymmetry and distortion of the breast contour may occur and reconstruction is sometimes required. The authors' aim is to conduct a review of main breast reconstruction options with local flaps after partial mastectomy. EVIDENCE ACQUISITION: A literature review was conducted on PubMed using the keywords: "partial breast reconstruction," "local flaps," "LICAP," "ICAP," "AICAP," "TDAP," "MS-LD" and "SAAP." Reviews, meta-analyses, clinical trials, experimental studies and case reports focused on breast reconstruction with local flaps after partial mastectomy (quadrantectomy or lumpectomy) were included in the study. Only English-written studies published in the past 20 years were considered eligible. Older articles, non-English written articles or papers regarding random flaps/video assisted harvested flaps/combined flaps were excluded. EVIDENCE SYNTHESIS: A cumulative number of 292 scientific articles was produced by the research. After screening by the two principal investigators, 73 articles were deemed eligible for full-text examination. In total, twenty-seven articles met the inclusions criteria. CONCLUSIONS: Local flaps are a safe and reliable option in breast reconstruction after partial mastectomy. They are associated with a low complication rate reported in the literature, with satisfactory aesthetic outcomes. Prospective multicenter clinical studies are desirable to confirm the results of this study.