The use of the thorac axillar flap for the immediate breast reconstruction of the upper lateral quadrantectomies and upper medial., concerning later aesthetic results and postoperative follow–up, from May/1997 to November/2006. Casuistic and Methods: This study was carried out in a Federal University of São Paulo – UNIFESP, São Paulo, Brazil, sixty four patients with breast cancer located in the upper lateral quadrant and upper medial quadrant, were underwent a immediate breast reconstruction with thorac-axillar flap, The age of the patients ranged from 29 to 81 years (mean 57). Respecting a clinical trial that is performed at the UNIFESP, (56%) patients had been treated previously with chemotherapy (5-fluoracil, ciclophospahamide and epirrusiciu). All these patients were submitted to postoperative radiationtherapy. The follow-up ranged from 12 months to 9 years. Evaluation of aesthetic results was carried out betwen one year at nine years of the postoperative follow-up and was based on opinion of patient and objetive evaluation was based on three criteria: asymmetry of nipples, loss of volume and retraction estimated by the medical team. Results: Viability was present in 100% of the flaps. 82% patients rated themselves excellent, and from the medical team the evaluation rated 93% excellent outcomes. The histological diagnoses were (78%) ductal carcinoma; (12%) mucinoso carcinoma ; (10) lobular carcinoma., 3 patients had local recurrence, and 2 were underwent mastectomy by insufficient margens. Conclusion: The flap showed a later excellent aesthetic result in immediate repair for upper lateral and upper medial quadrantectomies and the log-term, radiotherapy and quiomotherapy don't interered in the outcomes.
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