Sunday, October 28, 2007
13128

Later Results after Thorac Axillar Flap in Consertive Treatment

Elvio Bueno Garcia, PhD, Lydia Masako Ferreira, PhD, Miguel Sabino Neto, PhD, and Luis Eduardo Abla, MD, PhD.

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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