This is a retrospective non randomized study comparing the outcome and technical aspects of the TDAP and the LICAP for the reconstruction of partial breast defects.
Both techniques have been performed at different time frames at the same institution (National Cancer Institute of Cairo University) by the same surgical team. Indications were similar in both study groups namely:
Early stage breast cancer patients who required excision of 20% or more of their breast volume.
Patients requiring skin excision such as those:
With tumours close or attached to but not infiltrating the skin.
With misplaced scars of previous open biopsies, which needed wider excision due to infiltrated margins.
Breast cancer patiens with unfavourable breast/tumour ratio, who were downstaged by neoadjuvant chemotherapy to allow breast conservation.
Review of patients’ records between January 2011 – December 2019 revealed 52 cases of TDAP flap and 40 cases of LICAP technique who have completed their adjuvant treatment. Of those, only 46 cases of TDAP flap and 37 cases of LICAP flap have been accessible for this study.
Relevant clinical data were extracted from patients’ records. A special visit was organized for all 83 patients ,where a digital photograph was taken in an antroposterior view.
The photographs were later processed via BCCT.core software to obtain an objective cosmetic outcome assessment.
Results of both groups were recorded in tables and data were statistically described in terms of mean ± standard deviation (±SD), and, or frequencies (number of cases) and percentages when appropriate.
Comparison of numerical variables between the study groups was done using the Student t test for independent samples in normally distributed data and Mann-Whitney U test for independent samples in not normal data. For comparing categorical data, chi square (χ 2) test was performed. Exact test was used instead when the expected frequency is less than 5. p values less than 0.05 was considered statistically significant. All statistical calculations were done using computer program SPSS (Statistical Package for the Social Science; SPSS Inc., Chicago, IL, USA) release 15 for Microsoft Windows (2006).
The demographic data and comorbidities of the study groups are illustrated in the following table:
The clinical TNM stage for the study groups at initial presentation are illustrated in the following table:
Six patients of the TDAP group and three patients of the LICAP group received neoadjuvant chemotherapy for downstaging to enable breast conservation.
All patients in both groups underwent preoperative Doppler mapping to allocate the site of perforators preoperatively. In addition, intra-operative frozen section examination was done for all specimens in order to verify negative margins of excision before flap elevation was started.