Latissimus dorsi flap in breast reconstruction following radical mastectomy and prophylactic subcutaneous mastectomy in the same patient: Case report
DOI:
https://doi.org/10.61751/bmbr/4.2023.17Keywords:
mammoplasty, surgical correction, implant, myofascial repairAbstract
One of the most common surgical treatment options for breast cancer is radical mastectomy, which affects
the quality of life of patients in remission and their psychological state. One of the solutions to this problem is the
use of skin and muscle flaps from other anatomical areas, in particular the back, for plastic reconstruction of the breast
after radical mastectomy. The study aimed to present the practical implementation of reconstruction of both breasts
in the remote period of radical mastectomy in a patient in remission of breast cancer using a skin and muscle flap of
the broadest back muscle in combination with an implant. The patient, who met the criteria for participation in the
study, had previously undergone a radical mastectomy of the right breast for direct indications along with radiotherapy.
Delayed breast reconstruction within the study was performed 6 years after the planned right-sided mastectomy. The first
surgical intervention included marking the back and breast area, excision and harvesting of the flap, preparation of the
implantation site and its placement with the implant. Three months after the operation, she underwent a prophylactic
mastectomy of the left breast based on molecular genetic testing with immediate reconstruction using the second flap of
the broadest back muscle. The surgery was performed using a perimammary approach. Due to the available dissection,
various anatomical configurations of the flap, and low-variability vascular anatomy, the latissimus dorsi flap is an adequate
choice of material for the reconstruction of radical postmastectomy interventions. The final result of bilateral use of the
flap for breast reconstruction after mastectomy is in favour of restoration of the anatomical tissue defect and a satisfactory
aesthetic option, without complications in the form of seromas, haematomas, or pain. The result has a positive impact on
the quality of life of a patient in remission of breast cancer
Received: 08.08.2023 | Revised: 30.10.2023 | Accepted: 28.11.2023
References
Breast cancer statistics [Internet]. WCRF International; [cited 2023 Nov 29]. Available from: https://www.wcrf.org/cancer-trends/breast-cancer-statistics/
Lovelace DL, McDaniel LR, Golden D. Long‐term effects of breast cancer surgery, treatment, and survivor care. J Midwifery Women's Health. 2019;64(6):713–24. DOI: 10.1111/jmwh.13012
Kaidar-Person O, Offersen BV, Boersma LJ, de Ruysscher D, Tramm T, Kühn T, et al. A multidisciplinary view of mastectomy and breast reconstruction: Understanding the challenges. The Breast. 2021;56:42–52. DOI: 10.1016/j.breast.2021.02.004
Giaquinto AN, Sung H, Miller KD, Kramer JL, Newman LA, Minihan A, et al. Breast cancer statistics, 2022. CA Cancer J Clin. 2022;72(6):524–41. DOI: 10.3322/caac.21754
Kaufman CS. Increasing role of oncoplastic surgery for breast cancer. Curr Oncol Rep. 2019;21:e111. DOI: 10.1007/s11912-019-0860-9
Šalát D, Nikodemová D, Klepanec A, Lehotská V, Šalátová A. Diagnostic reference levels in screening mammography centers in Slovakia. Radiat Prot Dosim. 2022;198(9-11):537–39. DOI: 10.1093/rpd/ncac095
Cha HG, Kwon JG, Kim EK. Shaping an anatomical breast using extended latissimus dorsi flap and lipofilling in immediate breast reconstruction. Ann Plast Surg. 2020;85(5):476–80. DOI: 10.1097/SAP.0000000000002295
Danková Z, Grendár M, Dvorská D, Braný D, Stastny I, Bobrovská M, et al. miRNA profile of luminal breast cancer subtyptes in Slovak women. Ceska Gynekol. 2020;85(3):174–80.
Krasničanová L, Saade R, Priščáková P, Gbelcová H, Kaľavská K, Karaba M, et al. Pilot study of gene mutations associated with Lynch syndrome in Slovak patients with breast cancer. Klin Onkol. 2023;36(2):130–34. DOI: 10.48095/ccko2023130
Waks AG, Winer EP. Breast cancer treatment: A review. JAMA. 2019;321(3):288–300. DOI: 10.1001/jama.2018.19323
Koczkodaj P, Sulkowska U, Gotlib J, Mańczuk M. Breast cancer mortality trends in Europe among women in perimenopausal and postmenopausal age (45+). Arch Med Sci. 2020;16(1):146–56. DOI: 10.5114/aoms.2019.85198
Qian B, Xiong L, Li J, Sun Y, Sun J, Guo N, et al. A systematic review and meta-analysis on microsurgical safety and efficacy of profunda artery perforator flap in breast reconstruction. J Oncol. 2019;e9506720. DOI: 10.1155/2019/9506720
The World Medical Association. Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects [Internet]. Available from: https://www.wma.net/what-we-do/medical-ethics/declaration-of-helsinki/
Wilkinson L, Gathani T. Understanding breast cancer as a global health concern. Br J Radiol. 2022;95(1130):e20211033. DOI: 10.1259/bjr.20211033
Char S, Bloom JA, Erlichman Z, Jonczyk MM, Chatterjee A. A comprehensive literature review of patient‐reported outcome measures (PROMs) among common breast reconstruction options: What types of breast reconstruction score well? Breast J. 2021;27(4):322–29. DOI: 10.1111/tbj.14186
Nam SB, Oh HC, Choi JY, Bae SH, Choo KS, Kim HY, et al. Volumetric change of the latissimus dorsi muscle after immediate breast reconstruction with an extended latissimus dorsi musculocutaneous flap. Arch Plast Surg. 2019;46(2):135–39. DOI: 10.5999/aps.2017.01690
Thomsen JB, Rindom MB, Rancati A, Angrigiani C. Thoracodorsal artery flaps for breast reconstruction – the variants and its approach. Arch Plast Surg. 2021;48(1):15–25. DOI: 10.5999/aps.2020.01410
Wattoo G, Nayak S, Khan S, Morgan J, Hocking H, MacInnes E, et al. Long-term outcomes of latissimus dorsi flap breast reconstructions: A single-centre observational cohort study with up to 12 years of follow up. J Plast Reconstr Aesthetic Surg. 2021;74(9):2202–9. DOI: 10.1016/j.bjps.2020.12.058
Rindom MB, Gunnarsson GL, Lautrup MD, Christensen RD, Tos T, Hölmich LR, et al. Shoulder-related donor site morbidity after delayed breast reconstruction with pedicled flaps from the back: An open label randomized controlled clinical trial. J Plast Reconstr Aesthet Surg. 2019;72(12):1942–49. DOI: 10.1016/j.bjps.2019.07.027
Tevlin R, Wan DC, Momeni A. Should free deep inferior epigastric artery perforator flaps be considered a quality indicator in breast reconstruction? J Plast Reconstr Aesthet Surg. 2019;72(12):1923–29. DOI: 10.1016/j.bjps.2019.08.005
Archangelo SD, Sabino M, Veiga DF, Garcia EB, Ferreira LM. Sexuality, depression and body image after breast reconstruction. Clinics. 2019;74:e883. DOI: 10.6061/clinics/2019/e883
Beugels J, Levine JL, Vasile JV, Craigie JE, Allen Sr RJ. The delay procedure in deep inferior epigastric artery perforator flap breast reconstruction. Plast Reconstr Surg. 2023. DOI: 10.1097/PRS.0000000000010837
Mortada H, AlNojaidi TF, AlRabah R, Almohammadi Y, AlKhashan R, Aljaaly H. Morbidity of the donor site and complication rates of breast reconstruction with autologous abdominal flaps: A systematic review and meta-analysis. Breast J. 2022;e7857158. DOI: 10.1155/2022/7857158
Boczar D, Huayllani MT, Forte AJ, Rinker B. Microsurgical breast reconstruction in the obese patient using abdominal flaps: Complication profile and patient satisfaction. Ann Plast Surg. 2020;84(6):361–63. DOI: 10.1097/SAP.0000000000002284
Palve JS, Luukkaala TH, Käriäinen MT. Predictive risk factors of complications in different breast reconstruction methods. Breast Cancer Res Treat. 2020;182:345–54. DOI:
1007/s10549-020-05705-3
Sousa H, Castro S, Abreu J, Pereira MG. A systematic review of factors affecting quality of life after postmastectomy breast reconstruction in women with breast cancer. Psycho‐Oncol. 2019;28(11):2107–18. DOI: 10.1002/pon.5206
Soon PS, Ruban S, Mo HTJ, Lee R, Saliba L, Shah A, et al. Understanding patient choices regarding breast reconstruction after mastectomy for breast cancer. Support Care Cancer. 2019;27:2135–42. DOI: 10.1007/s00520-018-4470-0
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Bulletin of Medical and Biological Research

This work is licensed under a Creative Commons Attribution 4.0 International License.











