Background: Locally advanced breast cancer (LABC) is still a common problem in developing countries. Extensive resections are aimed at local control and improving quality of life. Dermofat flaps are an option for medium-sized defects.
Objectives: Evaluate the results of a new thoracoabdominal flap (TAF).
Methods: We describe and evaluate an ipsilateral, thoracoabdominal horizontal, dermofat (ITADE) flap performed in patients submitted to mastectomy and immediate reconstruction. A systematic review of the flaps used in this situation was performed.
Results: A total of 23 patients underwent the ITADE flap. The average flap size was 360 cm2 . One (4.3%) patient presented extensive loss of the flap. In the literature review, we observed 354 patients with 159 TAFs. We added our cases to the evaluation. A significant reduction in the risk of necrosis using myocutaneous flaps versus TAFs was observed (P < 0.001). Comparing other TAFs and ITADE flaps, considering all necrosis, a significant difference was apparent (P = 0.02), which disappeared when evaluating only larger necrosis (P = 0.13). Multivariate analysis showed that the resected area was the best variable related to the presence of necrosis.
Conclusions: ITADE allows extensive coverage areas, an early start of adjuvant treatment and it can be performed without requiring a reconstructive team.
Keywords: breast cancer; locally advanced breast cancer; mastectomy; surgical flaps; thoracoabdominal flaps.
© 2017 Wiley Periodicals, Inc.