Reconstruction of Severe Breast Deformities following Conservative Cancer Surgery and Radiation Therapy with a Latissimus Dorsi Myocutaneous Flap.

Conservative surgery of selected breast-cancer tumors up to 4 cm in size gives rise to equivalent overall survival rates in both retrospective and randomized chmcal trials. Although 90 percent of patients display satisfactory functional and cosmetic results when surgery is performed by highly competent teams, the remaining 10 percent end up with severe breast deformities due to factors such as inappropriate selection of patients, poor surgical techniques, postradiation fibrosis and scar contractures. These patients also suffer from painful, hard, edematous breasts. Severe breast deformities are always associated with malpositioning and distortion of the nipple-areola complex. Significant contour abnormalities, characterized by retraction and depression, may hinder reconstruction by the plastic surgeon if the patient wishes to retain the residual breast.