Breast Cancer: Current Research
Open Access

Abdominal-based breast reconstruction; Autologous tissue; Deep inferior epigastric artery perforator (DIEP) flap; transverse rectus abdominis myocutaneous (TRAM) flap

Methodology

Study design: The researchers may choose a retrospective study design, prospective study design, or a systematic review and metaanalysis approach. The study design will depend on the research objectives and available data.

Participant selection: Researchers typically select patients who have undergone abdominal-based breast reconstruction procedures. The selection criteria may include factors such as age, previous breast surgery, body mass index (BMI), and comorbidities.

Data collection: Relevant data is collected, which may include patient demographics, medical history, surgical techniques utilized, complication rates, aesthetic outcomes, and patient-reported satisfaction. Data may be collected from medical records, patient surveys, and clinical follow-up visits.

Surgical techniques: The specific surgical techniques employed in abdominal-based breast reconstruction, such as the deep inferior epigastric artery perforator (DIEP) flap or transverse rectus abdominis myocutaneous (TRAM) flap, may be described in detail. This includes information on flap harvest, vessel anastomosis, flap inset, and postoperative care.

Outcome measures: Researchers assess various outcome measures, such as complication rates (e.g., flap necrosis, infection), aesthetic outcomes (e.g., symmetry, shape, and projection), patient satisfaction scores, and quality of life assessments.

Statistical analysis: Statistical analysis is conducted to analyze the collected data. This may involve descriptive statistics, chi-square tests, t-tests, regression analysis, or other appropriate statistical methods, depending on the research questions and the nature of the data.

Advantages of abdominal-based breast reconstruction: The discussion may focus on the advantages of using abdominal tissue for breast reconstruction. This could include factors such as the availability of ample donor tissue, the potential for achieving natural-looking results, reduced donor site morbidity compared to alternative methods, and the potential for simultaneous abdominal contouring [1-5].

Discussion

Comparison of surgical techniques: The study might compare different abdominal-based surgical techniques, such as the deep inferior epigastric artery perforator (DIEP) flap and transverse rectus abdominis myocutaneous (TRAM) flap. The discussion could delve into the advantages and disadvantages of each technique, including factors such as flap viability, aesthetic outcomes, complication rates, and impact on abdominal muscle function.

Aesthetic outcomes and patient satisfaction: The discussion might highlight the importance of achieving satisfactory aesthetic outcomes and patient satisfaction in abdominal-based breast reconstruction. It could explore factors that contribute to favorable aesthetic outcomes, such as flap design, flap inset techniques, and meticulous microsurgical anastomosis. Patient-reported outcomes, quality of life assessments, and long-term satisfaction rates may also be discussed.

Complications and challenges: The discussion may address potential complications associated with abdominal-based breast reconstruction, such as flap necrosis, wound infection, seroma formation, and abdominal wall weakness. Strategies for minimizing complications and overcoming challenges, such as patient selection, surgical expertise, and postoperative care protocols, may be explored.

Emerging technologies and future directions: The study might discuss emerging technologies and advancements in abdominal-based breast reconstruction. This could include the use of preoperative imaging techniques (e.g., computed tomography angiography) to optimize flap design, refine perforator selection, and improve surgical planning. The potential role of robotic-assisted surgery, tissue engineering, and regenerative medicine in the future of abdominal-based breast reconstruction may also be addressed. The discussion might delve into the clinical implications of abdominal-based breast reconstruction, including considerations for patient selection, shared decision-making with patients, and factors influencing the choice between autologous tissue reconstruction and implant-based reconstruction [6-10].

Conclusion

In conclusion, abdominal-based breast reconstruction techniques have evolved significantly in the modern era, offering numerous advantages and advancements in the field of breast surgery. The utilization of autologous tissue, such as the deep inferior epigastric artery perforator (DIEP) flap and transverse rectus abdominis myocutaneous (TRAM) flap, provides ample donor tissue, enhances aesthetic outcomes, and minimizes donor site morbidity. The future of abdominal-based breast reconstruction is likely to witness the integration of emerging technologies, which can enhance surgical planning, refine perforator selection, and optimize patient outcomes. It is crucial for clinicians to stay abreast of these advancements and make informed decisions in the best interest of their patients. Overall, abdominal-based breast reconstruction techniques have emerged as an effective option in the modern era, offering improved aesthetic outcomes, patient satisfaction, and minimized donor site morbidity. Continued research, technological advancements, and clinical expertise will further enhance the field, ensuring that patients receive the most optimal and individualized reconstructive options available.

Acknowledgment

None

Conflict of Interest

None

1. Brunt AM, Haviland JS, Wheatley DA, Sydenham MA, Alhasso A, et al. (2020) Hypofractionated breast radiotherapy for 1 week versus 3 weeks (FAST-Forward): 5-year efficacy and late normal tissue effects results from a multicentre, non-inferiority, randomised, phase 3 trial. Lancet 395: 1613-1626.

Indexed at, Google Scholar, Crossref

2. Mamounas EP, Bandos H, Lembersky BC, Jeong JH, Geyer Jr CE, et al. (2019) Use of letrozole after aromatase inhibitor-based therapy in postmenopausal breast cancer (NRG Oncology/NSABP B-42): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol 20: 88-99.

Indexed at, Google Scholar, Crossref

3. Coles CE, Aristei C, Bliss J, Boersma L, Brunt AM, et al. (2020) International guidelines on radiation therapy for breast cancer during the COVID-19 pandemic. Clin Oncol (R Coll Radiol) 32: 279-281.

Indexed at, Google Scholar, Crossref

4. Metzger Filho O, Giobbie Hurder A, Mallon E, Gusterson B, Viale G, et al.(2015) Relative effectiveness of letrozole compared with tamoxifen for patients with lobular carcinoma in the BIG 1‐98 trial.J Clin Oncol33: 2772–2779.

Indexed at, Google Scholar, Crossref

5. Arps DP, Healy P, Zhao L, Kleer CG, Pang JC (2013) Invasive ductal carcinoma with lobular features: a comparison study to invasive ductal and invasive lobular carcinomas of the breast. Breast Cancer Res Treat 138: 719-726.

Indexed at, Google Scholar, Crossref

6. Xiao Y, Ma D, Ruan M, Zhao S, Liu XY, et al. (2017) Mixed invasive ductal and lobular carcinoma has distinct clinical features and predicts worse prognosis when stratified by estrogen receptor status. Sci Rep 7: 1-9.

Indexed at, Google Scholar, Crossref

7. Curtis C, Shah S.P, Chin S.F, Turashvili G (2012) METABRIC Group The genomic and transcriptomic architecture of 2,000 breast tumours reveals novel subgroups. Nature 486:346-352.

Indexed at, Google Scholar, Crossref

8. Timmers C, Sharma N, Opavsky R, Maiti B (2007) E2f1, E2f2, and E2f3 control E2F target expression and cellular proliferation via a p53-dependent negative feedback loop. Mol. Cell. Biol 27:65-78.

Indexed at, Google Scholar, Crossref

9. Chen HZ, Tsai SY, Leone G (2009) Emerging roles of E2Fs in cancer: an exit from cell cycle control. Nat. Rev. Cancer 9:785–797.

Indexed at, Google Scholar, Crossref

10. Johnson DG, Schwarz JK, Cress WD, Nevins JR (1993) Expression of transcription factor E2F1 induces quiescent cells to enter S phase. Nature 365:349-352.

Indexed at, Google Scholar, Crossref