Immediate Breast Reconstruction Using Microsurgery in Multidisciplinary Treatment for T4 Breast Cancer

Abstract

T4 breast cancer requires multidisciplinary treatment such as preoperative chemotherapy, surgery, postoperative radiation and chemotherapy. We report immediate breast reconstruction during multidisciplinary treatment for T4 breast cancer. We investigated the age, resection method, defect size, reconstruction method, complications, preoperative treatment, postoperative treatment and prognosis of patients with T4 breast cancer who underwent immediate breast reconstruction at our institution between December 2010 and March 2018. There were 10 patients, aged 24 to 65 years old (average 50.2 years old) . The resection methods were simple mastectomy in 7 and mastectomy with resection of the pectoral muscle in 3. The reconstruction methods were pedicled TRAM flap with additional anastomosis of the opposite side perforator in 7 and free DIEP flap in 3. Postoperative treatments consisted of radiation therapy and chemotherapy in 4, radiation therapy and hormone therapy in 4, radiation therapy alone 1, and chemotherapy alone in 1. As extensive defects must be reconstructed in T4 breast reconstruction, autologous tissue was useful for early wound healing after resection, enabling the early start of chemotherapy and radiation.