Abstract P2-15-07: Current status of latissimus dorsi flaps with or without implants for breast reconstruction in patients with breast tumor: A single-center retrospective study
Authors: Zheng Shuyue , Chen Jiajian , Hao Shuang , Yang Benlong , Huang Xiaoyan , Liu Guangyu , Wu Jiong 
Published: March 2023

Abstract
Background: Asian women have relatively small breast sizes compared to European American women, so the latissimus dorsi flap (LDF) is the most commonly used autologous flap for breast reconstruction in Chinese patients with breast tumor. To explore the current status of LDF with or without implants (IMP) breast reconstruction in China, we conducted this study. Methods: This study was a single-center retrospective study that included breast tumor patients who underwent LDF breast reconstruction in Fudan University Shanghai Cancer Center (FUSCC) from 2000 to 2019. The basic clinicopathological information, the timing and type of reconstruction, postoperative hospitalization time and serious complications requiring surgical intervention were analyzed. Continuous variables were expressed as mean values or median values, while categorical variables were expressed as frequencies. Data were analyzed by using Chi-square and Kruskal-Wallis tests. All P values reported were two-sided and were calculated at a significance level of 0.05. Results: A total of 2868 patients who underwent breast reconstruction for breast tumor were analyzed in this study, 785 (27.4%) patients used LDF for breast reconstruction, and 397 (13.8%) patients underwent autologous breast reconstruction utilizing abdominal flap. The number of breast reconstruction patients and the diversity of reconstruction procedures were increasing year by year. Breast reconstructions utilizing LDF have decreased as a percentage of breast reconstructions, but have increased in number in the past few years. Among patients with LDF breast reconstruction, the majority (97.3%) underwent immediate reconstruction, 11 patients underwent delay reconstruction, and 10 patients underwent immediate-delay reconstruction. 448 patients underwent expanded LDF breast reconstruction, and 337 (42.9%) patients underwent LDF combined with IMP breast reconstruction. 13 patients underwent restoration of reconstructed breast with LDF, 12 of which were changed to LDF±IMP reconstruction due to unsatisfactory outcome of expander reconstruction or failed implant reconstruction, and one patient was changed to LDF reconstruction from failed abdominal flap reconstruction. In terms of pathological type, 629 (80.1%) patients had invasive carcinoma, 129 (16.4%) had carcinoma in situ, 18 (2.3%) patients had phyllodes tumor and 9 (1.1%) patients had other malignancies. The median reconstruction age of the patients was 37 years old, the mean BMI was 21.76kg/cm2, and the mean postoperative length of stay was 11.13 days. There were no significant differences in postoperative hospitalization time, reconstruction age, BMI, pT, ER, PR, HER2, Ki67, and radiotherapy between patients with expanded LDF and LDF combined with IMP breast reconstruction. Patients with neoadjuvant therapy (P=0.045), phyllodes tumors or other malignant tumors (P=0.023), and those with more metastatic lymph nodes (P=0.031) were tent to expanded latissimus dorsi flap reconstruction. Serious complications requiring surgical intervention occurred in 13 patients (1.65%), including 7 patients who underwent surgical debridement or scar repair due to wound infection and poor healing, and 3 patients who removed the implant due to implant infection. The reconstructed latissimus dorsi flaps necrosis occurred in 3 patients, and the reconstructed breasts were removed in these patients. There was no significant difference in the incidence of serious complications requiring surgical intervention between patients with expanded LDF and those with LDF combined with implant reconstruction, P=0.79. Conclusions: LDF±IMP breast reconstruction is a mature breast reconstruction procedure in our center with high safety. Whether combined with implant reconstruction did not affect the postoperative hospitalization time and the incidence of serious complications.
Citation Format: Shuyue Zheng, Jiajian Chen, Shuang Hao, Benlong Yang, Xiaoyan Huang, Guangyu Liu, Jiong Wu. Current status of latissimus dorsi flaps with or without implants for breast reconstruction in patients with breast tumor: A single-center retrospective study [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-15-07.