Lateral transpositional flaps (LTF) in management of outer quadrant breast cancer: An assessment of the oncological safety and cosmetic outcome

Background: The incorporation of plastic surgery techniques in breast-conserving surgery (BCS) for breast cancer and the emergence of oncoplastic breast surgery (OBS) was an evolution in breast cancer surgery. It allows wider excisions with better oncological and aesthetic outcomes. The aim of the study is to present the lateral transpositional flap (LTF) from the lateral wall of the chest as an alternate option for latissimus dorsi myocutaneous flap LDMF with a precise patient selection.Patients and methods: From January 2021 till March 2024, forty female patients diagnosed with outer quadrants breast cancer were operated upon using quadrantectomy and lateral transpositional flaps reconstruction LTF. Follow-up was planned for at least 12 months for the post-operative complications and the aesthetic outcome as well as the impact on the shoulder functions.Results: The mean age of patients was 38.7 ± 7.39 years. Four patients received neoadjuvant chemotherapy (NACT) for downgrading of tumor size. The mean mammographic tumor size was 1.9 ± 1 x 1.7± 0.9. The mean weight of resected specimens was 65.5±6.7 gms. Only 2 patients developed minor wound complications which were managed conservatively without the need for any revisional surgery. Only two patients presented with fat necrosis. Only one patient developed loco-regional recurrence with no distant metastasis. No cases reported any shoulder dysfunctions.Conclusion: According to the current results, The lateral transpositional flaps (LTF) is an effective, reliable, and feasible technique for breast reconstruction for outer quadrant breast cancer in carefully selected patients. It is oncologically safe with low morbidity and good cosmetic outcome.