World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access
Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc
Journal website https://wjon.elmerpub.com

Original Article

Volume 16, Number 6, December 2025, pages 621-629

Immediate Breast Reconstruction Using an Expanded Latissimus Dorsal Musculocutaneous Flap Without Body Position Change

Figures

↓  Figure 1. Intraoperative images. (a) Preoperative back skin incision design. (b) Preoperative breast design. (c) Flap moved to the prothorax. (d) Flap folded in two and formed into the breast shape.
Figure 1.
↓  Figure 2. Postoperative images of the representative four patients with small-sized breasts.
Figure 2.
↓  Figure 3. Postoperative images of the representative four patients with standard-sized breasts.
Figure 3.
↓  Figure 4. Postoperative images of the representative four patients with large-sized breasts.
Figure 4.

Tables

↓  Table 1. Clinical and Pathological Characteristics of Breast Cancer Patients With and Without Immediate Reconstruction
 
Reconstruction Mastectomy alone P value
BMI: body mass index; ER: estrogen receptor; Her2: human epidermal growth factor receptor 2;PgR: progesterone receptor.
Length of follow-up, months (median) 58 (0 - 124) 56 (0 - 118) 0.8423
No. of cases 223 48
Age (average) 49.7 (24 - 80) 64.1 (36 - 90) < 0.0001
BMI (median) 21.8 (17.2 - 37.7) 20.7 (17.3 - 32.9) 0.0793
Pathology 0.0182
  Ductal carcinoma in situ 53 12
  Lobular carcinoma in situ 0 2
  Invasive ductal carcinoma 140 24
  Invasive lobular carcinoma 8 3
  Others 22 7
Stage 0.6967
  0 53 14
  I 114 20
  IIA 38 9
  IIB 16 5
  IIIA 2 0
ER 0.0017
  Positive 182 33
  Negative 41 13
  Uncertain 0 2
PgR 0.0008
  Positive 163 25
  Negative 60 21
  Uncertain 0 2
Her2 0.8873
  Positive 33 6
  Negative 169 37
  Uncertain 21 5
Adjuvant endocrine therapy 175 29 0.0330
Adjuvant chemotherapy 24 4 0.7942
Adjuvant radiotherapy 3 1 < 0.0001
Smoking 22 6 < 0.0001
Diabetes 10 4 < 0.0001

 

↓  Table 2. Comparisons of Operation Time, Blood Loss, and Surgery Method of Breast Between Our Study and Report by Sakai et al [15]
 
Our study Sakai et al [15]
Ax: axilla dissection; NSM: nipple-sparing mastectomy; SNB: sentinel lymph node biopsy; SSM: skin-sparing mastectomy.
No. of cases 223 174
Operation time (median), min 183.6 (115 - 191) 418
Blood loss (median), mL 73.2 (5 - 322) 618
Surgery method of breast
  NSM 107 2
  NSM + SNB 85 2
  NSM + SNB → Ax 9 0
  NSM + Ax 7 0
  NSM + SNB → SSM 1 0
  NSM + SNB → SSM + Ax 1 0
  SSM + SNB 5 108
  SSM + SNB → Ax 1 0
  SSM+Ax 1 51

 

↓  Table 3. Complication With Immediate Reconstruction
 
No. of cases % (N = 130/223) Sakai et al [15]
No. of total complication 130/223 (58.3%) 120/174 (69.0%)
Complication
  Donor site seroma 103 79.2/46.2 71 cases (41%)
  Wound detachment 9 6.9/4.0 43 cases (24.6%)
  Nipple necrosis 8 (partial only) 6.2/3.6 Four cases (2.3%)
  Flap infection 5 2.0/2.2 One case (0.5%)

 

↓  Table 4. Risk Factor of Seroma
 
Characteristics HR (95% CI) P-value
BMI: body mass index; CI: confidence interval; HR: hazard ratio.
Age > 50 years 0.529 0.0202
BMI > 21.5 kg/m2 0.394 0.0007
Operation time > 173 min 0.582 0.0505

 

↓  Table 5. Aesthetic Grading Results of Breast Reconstruction
 
Aesthetic grade No. of cases % Du et al [17], % Adel et al [18], %
Excellent 153 68.6 58.7 60.8
Good 55 24.7 30.2 30.0
Fair 7 3.1 7.9 7.1
Poor 1 0.4 3.2 2.1
Uncertain 7 3.1 0.0 0.0