Introduction: Breast conservation therapy (BCT) has evolved as an oncologically equivalent approach to mastectomy in select patients with early breast cancer. Immediate breast reconstruction with autologous tissue provides a viable option for improved cosmetic outcome. We report our experience with BCT followed by immediate latissimus dorsi myocutaneous flap (LDMF) reconstruction.

Methods: Twenty-four patients underwent BCT with immediate LDMF reconstruction from 1996-2000. Medical records were reviewed for pathologic staging and tumor recurrence. A survey was conducted to determine patient satisfaction based on symmetry, nipple position/sensation, and axillary fullness. Donor site morbidity with respect to pain, numbness, limitation of activity and scar deformity was assessed.

Results: All patients had early stage breast cancer. The predominant pathology was infiltrating ductal carcinoma (75%). With a median follow-up of 48 months, 4 patients required completion mastectomies. Patient satisfaction was high and 95% considered their operation a valid alternative to mastectomy. Donor site morbidity was minimal and all patients reported good to excellent nipple sensation. No interference with follow-up mammography was seen. LDMF tolerance to radiation was good.

Conclusion: BCT with immediate LDMF reconstruction provides a viable alternative for the management of breast cancer in patients who express a desire to preserve breast tissue and cosmesis.