OMENTAL TRANSPOSITION FLAP FOR GROSS LOCALLY RECURRENT BREAST-CANCER

Background: The omentum has been employed to cover the defect produced after resection of gross breast cancer recurrence for nearly three de cades. Methods: A series of 11 patients undergoing omental transpositi on flap for very wide resection of gross local recurrence (LR) of brea st cancer is reported. The median age was 39 years, with a short inter val (median = 21 months) from the treatment of the primary tumour to L R. Local recurrence was gross and predominantly inflammatory. Results: All except one patient had lymphovascular invasion in the recurrent t umour. The omental graft was 100% viable but one patient required re-a pplication of further split-thickness skin graft. The mean hospital st ay was 16 days. Two cases of seroma formation were encountered. New re currence developed around the periphery of the flap in eight patients after a median duration of local control of only 2.5 months. Eight pat ients died with metastatic disease after a median period of 6 months, six patients with uncontrolled local disease. Five patients were free from LR in over half of their remaining period of life. Conclusion: Om entoplasty is a safe and reliable procedure but the length of palliati on achieved is often far from satisfactory.