Reconstructive management of advanced breast cancer

To evaluate morbidity, quality of life, and oncological outcomes of patient s with advanced breast cancer, recurrence, or sequelae secondary to radioth erapy, the authors present their experience with 21 patients at the Institu to Nacional de Cancerologia in Mexico City, who underwent resection of the lesion and reconstruction using thoracoepigastric fasciocutaneous, rectus a bdominis, or latissimus dorsi musculocutaneous flaps. Complications include d partial flap necrosis and bronchopleural fistulae in 2 of 7 patients with whole-thickness chest wall resection. The remaining patients progressed ni cely, with a short recovery period. The patients and the surgical team eval uated results in terms of aesthetics and function using questionnaires. The results were from fair to good according to Sneeuw's scale. Pedicled muscu locutaneous and fasciocutaneous flaps are an excellent reconstructive optio n in patients with advanced, recurrent breast cancer and in those with radi onecrotic complications, which sometimes require resection of the whole-thi ckness chest wall.