Results
The profiles of all nine female patients are presented in Table 1. The
mean age of the patients was 64.78 years (range, 44–85 years) and their
mean BMI was 27.12 kg/m2 (range, 21.90–35.87
kg/m2); one of them was obese (BMI > 30).
None of the patients smoked. Of the three patients with comorbidities,
one had type II diabetes mellitus (DM), and the other two had received
neoadjuvant chemotherapy. All of them were in the advanced stage of
breast cancer and underwent unilateral MRM. One of them received delayed
reconstruction. The mean size of the defect area after MRM and skin
graft size for reconstruction were 399 and 240 cm2,
respectively. Most of the skin graft was harvested from the scalp,
followed by the thigh area. We applied NPWT at −50 mmHg in the
continuous mode for four days. After two weeks, the mean graft take was
96.11%. Two of them developed seroma and required aspiration at the
donor site. Partial skin graft necrosis occurred in one patient, and
healed after wound care.
Case1
The first case was a 59-year-old woman diagnosed with infiltrating
ductal carcinoma of left breast, cT4bN1M1, stage IV. She had received
neoadjuvant chemotherapy with epirubicin and cyclophosphamide followed
by docetaxel. Surgical intervention with left MRM + axillary lymph node
dissection (ALND) combined with LD muscle flap + STSG harvested from the
scalp was performed smoothly (Fig. 1A, 1B). After immediate breast
reconstruction, we applied NPWT over the entire wound at −50 mmHg in the
continuous mode for four days (Fig. 1C). The patient exhibited
satisfactory results at 3 months after the surgery (Fig. 1D).
Case 2
The second patient was a 57-year-old woman diagnosed with invasive
lobular carcinoma of left breast, cT4bN2M1, stage IV, with liver and
bone metastasis. She had received neoadjuvant chemotherapy with Taxatere
+ Herceptin prior to the surgery. Left breast MRM + ALND was performed,
combined with LD flap + STSG (Fig. 2A, 2B). NPWT was applied
postoperatively for four days (Fig. 2C). The progression was fair
without any complication. The patient exhibited satisfactory results at
three months after the surgery (Fig. 2D).