ONCOLOGIC AND COSMETIC ONTCOME IN PATIENTS WITH BREAST-CANCER TREATEDWITH WIDE EXCISION, TRANSPOSITION OF ADIPOSE-TISSUE WITH LATISSIMUS-DORSI MUSCLE, AND AXILLARY DISSECTION FOLLOWED BY RADIOTHERAPY

We evaluated the oncologic and cosmetic outcome in patients with breas t cancer treated with wide excision, transposition of adipose tissue w ith latissimus dorsi muscle (LDM), and axillary dissection followed by radiotherapy. In this study, a wide excision of breast tissue was per formed to obtain tumor-free margins. The subsequent breast deformity w as not corrected in six patients in the early phase of the study (Grou p 1), and in 16 patients in the late phase (Group 2) in which the brea st deformity was not remarkable at the time of operation. Breast defor mity was corrected by transposing adipose tissue with LDM on a vascula r pedicle in the remaining 51 patients (Group 3). Five year survival w as 100%. Two patients developed distant metastases. None were found to have local recurrence. Fifty percent of the Group 1 patients, 69% of the Group 2 patients, and 67% of the Group 3 patients had an excellent or good cosmetic result. However, when the cosmetic results were eval uated in patients who underwent transposition and had small breasts, t he results were excellent or good in 76%, compared to 38% in the patie nts who had reconstructions who had large breasts. The difference was statistically significant (p = 0.0309). Therefore, it was confirmed th at wide excision and axillary dissection followed by breast radiation could provide adequate local control, but frequently resulted in breas t deformity. However, transposition of adipose tissue may be useful to correct the breast deformity, especially in women with small breasts.