Keystone Perforator Island Flap for Postmastectomy Defect Resurfacing in Late-stage Breast Cancer Patients
Background:. Late-stage breast cancer usually presents with locally advanced disease, with or without metastasis. The primary tumor is typically large with skin infiltration which affects quality of life. Surgical resection will result in an extensive defect which potentially deteriorates patients’...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2019-11-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000002457 |
| _version_ | 1818328940627886080 |
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| author | Irena Sakura Rini, MD, MARS Made Ananda Krisna, MD Jenisa Kamayana, MD Kasih Rahardjo Djarot, MD Alberta Jesslyn Gunardi, MD |
| author_facet | Irena Sakura Rini, MD, MARS Made Ananda Krisna, MD Jenisa Kamayana, MD Kasih Rahardjo Djarot, MD Alberta Jesslyn Gunardi, MD |
| author_sort | Irena Sakura Rini, MD, MARS |
| collection | DOAJ |
| description | Background:. Late-stage breast cancer usually presents with locally advanced disease, with or without metastasis. The primary tumor is typically large with skin infiltration which affects quality of life. Surgical resection will result in an extensive defect which potentially deteriorates patients’ quality of life if not properly managed. Keystone perforator island flap (KPIF) is a local advancement flap based on multiple perforators which can be a reliable reconstructive method to close an extensive defect.
Methods:. This is a case series of 11 patients with symptomatic late-stage breast cancers indicated for neoadjuvant chemotherapy and subsequent mastectomy at Dharmais Cancer Hospital. The postmastectomy defect was closed with KPIF and clinical evaluation included flap success rate, percentage of flap necrotic area, and quality of life. There are modifications of the KPIF consisting of the more rounded shape and additional flap movement of the flap’s distal lateral ends to the center resembling an “omega” conformation.
Results:. Mean percentage of flap necrosis area was 9.7% and none of the patients needed additional surgery. The patients’ quality of life evaluated using Patient-reported Aesthetic European Organization for Research and Treatment of Cancer (EORTC) Quality of Life, Questionnaire-Core 30-questions (QLQ-C30) and Quality of Life, Questionnaire-Breast Cancer-23-questions (QLQ-BR23) was fair, with sufficiently good scores for global health status and functional scale, and minimal symptomatology burden. The lowest score was for fatigue and financial difficulties parameters from QLQ-C30 and sexual functioning and future perspective from QLQ-BR23.
Conclusion:. This is a preliminary study to show that a KPIF could be considered as a method for defect-resurfacing reconstruction after mastectomy. |
| first_indexed | 2024-12-13T12:40:09Z |
| format | Article |
| id | doaj.art-0e67ff94ba614bcabdcbf67e6c304d2f |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-12-13T12:40:09Z |
| publishDate | 2019-11-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-0e67ff94ba614bcabdcbf67e6c304d2f2022-12-21T23:45:40ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742019-11-01711e245710.1097/GOX.0000000000002457201911000-00009Keystone Perforator Island Flap for Postmastectomy Defect Resurfacing in Late-stage Breast Cancer PatientsIrena Sakura Rini, MD, MARS0Made Ananda Krisna, MD1Jenisa Kamayana, MD2Kasih Rahardjo Djarot, MD3Alberta Jesslyn Gunardi, MD4From the *Department of Plastic Surgery, Dharmais Cancer Hospital, West Jakarta, DKI Jakarta, Indonesia†Department of Surgery, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Central Jakarta, DKI Jakarta, Indonesia‡Prima Medika General Hospital, Denpasar, Bali, Indonesia.†Department of Surgery, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Central Jakarta, DKI Jakarta, IndonesiaFrom the *Department of Plastic Surgery, Dharmais Cancer Hospital, West Jakarta, DKI Jakarta, IndonesiaBackground:. Late-stage breast cancer usually presents with locally advanced disease, with or without metastasis. The primary tumor is typically large with skin infiltration which affects quality of life. Surgical resection will result in an extensive defect which potentially deteriorates patients’ quality of life if not properly managed. Keystone perforator island flap (KPIF) is a local advancement flap based on multiple perforators which can be a reliable reconstructive method to close an extensive defect. Methods:. This is a case series of 11 patients with symptomatic late-stage breast cancers indicated for neoadjuvant chemotherapy and subsequent mastectomy at Dharmais Cancer Hospital. The postmastectomy defect was closed with KPIF and clinical evaluation included flap success rate, percentage of flap necrotic area, and quality of life. There are modifications of the KPIF consisting of the more rounded shape and additional flap movement of the flap’s distal lateral ends to the center resembling an “omega” conformation. Results:. Mean percentage of flap necrosis area was 9.7% and none of the patients needed additional surgery. The patients’ quality of life evaluated using Patient-reported Aesthetic European Organization for Research and Treatment of Cancer (EORTC) Quality of Life, Questionnaire-Core 30-questions (QLQ-C30) and Quality of Life, Questionnaire-Breast Cancer-23-questions (QLQ-BR23) was fair, with sufficiently good scores for global health status and functional scale, and minimal symptomatology burden. The lowest score was for fatigue and financial difficulties parameters from QLQ-C30 and sexual functioning and future perspective from QLQ-BR23. Conclusion:. This is a preliminary study to show that a KPIF could be considered as a method for defect-resurfacing reconstruction after mastectomy.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000002457 |
| spellingShingle | Irena Sakura Rini, MD, MARS Made Ananda Krisna, MD Jenisa Kamayana, MD Kasih Rahardjo Djarot, MD Alberta Jesslyn Gunardi, MD Keystone Perforator Island Flap for Postmastectomy Defect Resurfacing in Late-stage Breast Cancer Patients Plastic and Reconstructive Surgery, Global Open |
| title | Keystone Perforator Island Flap for Postmastectomy Defect Resurfacing in Late-stage Breast Cancer Patients |
| title_full | Keystone Perforator Island Flap for Postmastectomy Defect Resurfacing in Late-stage Breast Cancer Patients |
| title_fullStr | Keystone Perforator Island Flap for Postmastectomy Defect Resurfacing in Late-stage Breast Cancer Patients |
| title_full_unstemmed | Keystone Perforator Island Flap for Postmastectomy Defect Resurfacing in Late-stage Breast Cancer Patients |
| title_short | Keystone Perforator Island Flap for Postmastectomy Defect Resurfacing in Late-stage Breast Cancer Patients |
| title_sort | keystone perforator island flap for postmastectomy defect resurfacing in late stage breast cancer patients |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000002457 |
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