THE CONTRALATERAL BREAST FLAP IN RECONSTRUCTION OF THE BREAST AND CHEST-WALL

The contralateral breast flap is a useful method of reconstruction of the breast and chest wall after the treatment of carcinoma of the brea st by surgery and x-ray therapy. Breast tissue is an excellent donor t issue to solve these difficult problems and the only disadvantage is t he risk of a second primary breast cancer. Young patients with an iden tifiable high risk of a second primary tumor are not suitable for this technique. If, however, we confine the operation to the group in whom we are prepared to preserve the breast, with or without a breast redu ction, then there is no logical reason why the risk should be any grea ter in having the residual breast tissue on two sides rather than one. The operation involves the transfer of breast tissue, normally discar ded in a breast reduction, to the other side in a two-stage procedure; this is a useful method, both for reconstruction of the breast and al so for repair of the chest wall after irradiation damage, particularly in elderly patients. I have found this technique to be suitable in ap proximately 10% of breast reconstructions I have performed; there has been no patient with a second primary tumor over a 15-year period in 6 0 carefully selected patients.