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Multicenter Study
. 2023 Oct:71:82-88.
doi: 10.1016/j.breast.2023.07.007. Epub 2023 Jul 17.

'PartBreCon' study. A UK multicentre retrospective cohort study to assess outcomes following PARTial BREast reCONstruction with chest wall perforator flaps

A Agrawal  1 , L Romics  2 , D Thekkinkattil  3 , M Soliman  4 , M Kaushik  5 , P Barmpounakis  6 , C Mortimer  7 , C A Courtney  8 , A Goyal  9 , E Garreffa  10 , A Carmichael  11 , R A Lane  12 , C Rutherford  13 , B Kim  14 , R Achuthan  15 , V Pitsinis  16 , S Goh  17 , B Ray  18 , K Grover  19 , R Vidya  20 , J Murphy  21 ; PartBreCon Collaborators  22
Collaborators, Affiliations
Multicenter Study

'PartBreCon' study. A UK multicentre retrospective cohort study to assess outcomes following PARTial BREast reCONstruction with chest wall perforator flaps

A Agrawal et al. Breast. 2023 Oct.

Abstract

Background: Partial breast reconstruction with a pedicled chest wall perforator flap (CWPF) enables breast conservation in a higher tumour: breast volume ratio scenario. Since there is limited evidence, this retrospective cohort study aimed to ascertain immediate (30-days) and medium-term (follow-up duration) surgical outcomes.

Methods: STROBE-compliant protocol ascertained CWPF outcomes between March 2011-March 2021. UK centres known to perform CWPF were invited to participate if they performed at least 10 cases. Data were retrospectively collected, including patient demographics, tumour and treatment characteristics, and surgical and oncological outcomes. Statistical analysis (R™) included multivariable logistic regression and sensitivity analysis.

Results: Across 15 centres, 507 patients with median age (54 years, IQR; 48-62), body mass index (25.4 kg/m2, IQR; 22.5-29), tumour size (26 mm, IQR; 18-35), and specimen weight (62 g, IQR; 40-92) had following flap types: LiCAP (54.1%, n = 273), MiCAP/AiCAP (19.6%, n = 99), LiCAP + LTAP (19.8%, n = 100) and TDAP (2.2%, n = 11). 30-days complication rates were in 12%: haematoma (4.3%, n = 22), wound infection (4.3%, n = 22), delayed wound healing (2.8%, n = 14) and flap loss (0.6%, n = 3; 1 full) leading to readmissions (2.6%, n = 13) and re-operations (2.6%, n = 13). Positive margins (n = 88, 17.7%) led to 15.9% (n = 79) re-excisions, including 7.5% (n = 37) at the planned 2nd of 2-stage surgery and 1.8% (n = 9) mastectomy. At median 23 months (IQR; 11-39) follow-up, there were 1.2% (n = 6) symmetrisations; recurrences: local (1%), regional/nodal (0.6%) and distant (3.2%).

Conclusions: This large multicentre cohort study demonstrates acceptable complication and margin re-excision rates. CWPF extends the range of breast conservation techniques. Further studies are required for long-term oncological outcomes.

Keywords: Chest wall perforator flap; LICAP; LTAP; Oncoplastic breast surgery; Partial breast reconstruction; TDAP.

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Conflict of interest statement

Declaration of competing interest None of the authors or collaborators declared any conflict of interest related to this project.

Figures

Image 1
Graphical abstract
Fig. 1
Fig. 1
Types of Flap performed.
See this image and copyright information in PMC

References

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