Breast Reconstruction with Dermal Flap in Benign Lesion Surgery with a High Risk of Malignancy
Keywords:
beast tumor, phyllodes tumor, capsular contracture, breast reconstruction.Abstract
Introduction: Although benign, breast expansion processes cause a deformity marked by excessive growth of the organ, leading to reconstructive techniques after its exeresis, individualized in each case. Although breast volume is lost, its projection and harmony are possible through autologous techniques that mold the remaining fatty tissue and dermis.
Objective: To show an alternative of breast reconstruction with dermal-fat flap and L closure in patients with tumor excision and breast explantation.
Presentation of clinical cases: The cases are presented of a 21-year-old patient with clinical picture of 2 years of evolution, consisting of an increase of volume in her right breast and with definitive diagnosis of phyllodes tumor; of a 55-old-patient with a history of augmentation mastoplasty from 22 years ago, who attended the office for consultation due to a clinical picture of 4 years of evolution consisting of pain at breast level, associated with a change in its shape and a feeling of hardening, corresponding to capsular contracture grade 4. As a surgical technique, after excision of the tumor and the encapsulated implant, the skin coverage was deepithelialized and the excess dermis was used as a filler to form the breast cone. The patients were satisfied in the absence of complications.
Conclusions: The present article offers a reconstructive variant to rebuild the breast and use, as a deep-filling plasty, the expanded excess skin deepithelialized as a local flap.
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Román M, Louro J, Posso M, Alcántara R, Peñalva L. Breast density, benign breast disease, and risk of breast cancer over time. Eur Radiol. 2021;31(7):4839-47. DOI: https://doi.org/10.1007/s00330-020-07490-5
Pardo R, Quintana R, Piñero A, Vázquez C, Cabañas J, Martínez F. Breast-implant associated anaplastic large-cell lymphoma. Consensus document (I). Epidemiology, pathogenesis, symptoms and diagnosis. Journal of Breast Science. 2019;32(2):61-6. DOI: https://doi.org/10.1016/j.senol.2019.05.001
Tamayo Carbón A, Vila García E, Cuastumal Figueroa D, Ariza Acuña D. Oncoplastic Surgery of Phyllodes Tumor of the Breast: Experience at Hermanos Ameijeiras Hospital. International Journal of Transplantation & Plastic Surgery. 2022;6(2):169. DOI: https://doi.org/10.23880/ijtps-16000169
Alkushi A, Arabi H, Al-Riyees L, Aldakheel AM, Al Zarah R, Alhussein F, et al. Phyllodes tumor of the breast clinical experience and outcomes: A retrospective cohort tertiary hospital experience. Ann Diagn Pathol. 2021;51:151702. DOI: https://doi.org/10.1016/j.anndiagpath.2021.151702
Pareja F, Da Cruz Paula A, Murray MP, Hoang T, Gularte Mérida R, Brown D. Recurrent MED12 exon 2 mutations in benign breast fibroepithelial lesions in adolescents and young adults. J Clin Pathol. 2019;72(3):258-62. DOI: https://doi.org/10.1136/jclinpath-2018-205570
Mustata L, Gica N, Botezatu R, Chirculescu R, Gica C, Peltecu G. Malignant Phyllodes Tumor of the Breast and Pregnancy: A Rare Case Report and Literature Review. Medicina (Kaunas). 2021;58(1):36. DOI: https://doi.org/10.3390/medicina58010036
Moraga Rodríguez A, Rodríguez Griñán A. Tumor filoide gigante. Presentación de un caso. Rev Inf Cient. 2023 [acceso 03/09/2023];102. Disponible en: https://revinfcientifica.sld.cu/index.php/ric/article/view/4257
Noordman P, Klioueva N, Weimann M, Borgstein P, Vrouenraets B. Phyllodes tumors of the breast: a retrospective analysis of 57 cases. Breast Cancer Res Treat. 2020;181(2):361-7. DOI: https://doi.org/10.1007/s10549-020-05620-7
Kuehlmann B, Burkhardt R, Kosaric N, Prantl L. Capsular fibrosis in aesthetic and reconstructive-cancer patients: A retrospective analysis of 319 cases. Clin Hemorheol Microcirc. 2018;70(2):191-200. DOI: https://doi.org/10.3233/CH-170365
Whaley R, Aldrees R, Dougherty R, Prieto C, Badve S, Al Diffalha S. Breast Implant Capsule-Associated Squamous Cell Carcinoma: Report of 2 Patients. Int J Surg Pathol. 2022;30(8):900-7. DOI: https://doi.org/10.1177/10668969221086940
Ramos G, Carballo A, Cuenca J, Vélez E, Contreras L, Bucio J. Linfoma anaplásico de células gigantes asociado a implantes mamarios. Cir Plast. 2023;33(1):36-44. DOI: https://doi.org/10.35366/110922
Moling O, Piccin A, Tauber M, Marinello P. Intravascular large B-cell lymphoma associated with silicone breast implant, HLA-DRB1*11:01, and HLA-DQB1*03:01 manifesting as macrophage activation syndrome and with severe neurological symptoms: a case report. J Med Case Rep. 2016;10(1):254. DOI: https://doi.org/10.1186/s13256-016-0993-5
Wee C, Younis J, Isbester K, Smith A, Wangler B, Sarode A, et al. Understanding Breast Implant Illness, Before and After Explantation: A Patient-Reported Outcomes Study. Ann Plast Surg. 2020;85(1):S82-6. DOI: https://doi.org/10.1097/SAP.0000000000002446
Venardi A, Newsom K, DeBrock W, Pittelkow E, Lester M, Fisher C, et al. The no-vertical scar technique for oncoplastic breast reconstruction. J Plast Reconstr Aesthet Surg. 2023;76:136-41. DOI: https://doi.org/10.1016/j.bjps.2022.10.013
Matsumine H, Niimi Y, Jibiki N, Sakurai H. Minimal Scar Autologous Breast Reconstruction with Skin-sparing Mastectomy. Plast Reconstr Surg Glob Open. 2023;11(8):e5176. DOI: https://doi.org/10.1097/GOX.0000000000005176
Schaverien M, Deigni O, Adamson K, Robb G. Complications of Wise-Pattern Compared With Vertical Scar Mastopexy/Breast Reduction in Oncoplastic Breast-Conserving Surgery. Ann Plast Surg. 2020;85(6):601-7. DOI: https://doi.org/10.1097/SAP.0000000000002392
AboShaban M, Abdelaty M. The Inferior-Based Dermoglandular Flap with Partial Subpectoral Implant Transposition and Revision Mastopexy for Subglandular Breast Augmentation Complications. Aesthetic Plast Surg. 2022;46(2):686-93. DOI: https://doi.org/10.1007/s00266-021-02576-x
Austin R, Yuan M, Lista F, Lapaine P, Ahmad J. Vertical Scar Mastopexy With a Centrally Based Auto-Augmentation Flap. Aesthet Surg J Open Forum. 2022;4:062. DOI: https://doi.org/10.1093/asjof/ojac062
Wang X, Mathews A, Erickson A, Veselack T, Bucholz E, Vandevender D, et al. Single Center Oncoplastic Experience and Patient Satisfaction Reported via Patient Reported Outcomes. Plast Reconstr Surg Glob Open. 2022;10(5):e4336. DOI: https://doi.org/10.1097/GOX.0000000000004336
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