Background: Volume replacement oncoplastic breast techniques have become one
of the standard lines in the treatment of early breast cancer. They have better
cosmetic outcome and patient satisfaction. Latissimus dorsi (LD) flap is one of
the most commonly used flaps for these techniques. Although it shows satisfactory
surgical outcomes, postoperative shoulder dysfunction is an obvious drawback.
The aim of this study was to compare LD flap with thoracodorsal artery perforator
(TDAP) flap after breast-conserving surgery regarding surgical outcomes, patient
satisfaction, and impact on shoulder function.
Methods: The study included 42 adult female patients with early breast cancer
who were eligible for conservative breast surgery and immediate breast reconstruction.
Patients were divided into 2 equal groups: group A where patients underwent
immediate reconstruction using LD flap and group B where patients underwent
reconstruction using TDAP flap. Follow-up was designed for 12 months for early
outcome, patient satisfaction, and shoulder functions.
Results: The mean age of the included patients in group A and group B was 40.95 ±
5.06 and 40.33± 5.25 years, respectively. There was no significant difference in flap
dimensions, postoperative complications, or cosmetic outcome in both groups.
However, significantly less shoulder dysfunction was documented in cases of TDAP
compared to LD flap at 3, 6, and 12 months postoperatively.
Conclusions: TDAP flap is as reliable a technique as LD flap regarding the feasibility,
postoperative complications, and the cosmetic outcome with significantly better
functional outcome of the shoulder. (Plast Reconstr Surg Glob Open 2019;7:e2476;
doi: 10.1097/GOX.0000000000002476; Published online 30 October 2019.)