Volume replacement (anterior intercostal artery perforator flap) versus volume displacement as a reconstructive mode in oncoplastic breast-conserving surgery: A retrospective study

This study aimed to investigate the potential advantages of anterior intercostal artery perforator (AICAP) flap compared to volume displacement (VD) in breast-conserving surgery for cancers located in the lower quadrant of medium to small-sized breasts. This retrospective comparative study analyzed 68 patients who underwent VD breast-conserving surgery and 27 patients who underwent AICAP flap breast-conserving surgery at the Affiliated Hospital of Southwest Medical University from 2022 to 2024. The patients were categorized into two cohorts: AICAP and VD cohorts. Statistical analysis was performed on baseline characteristics, Breast-Q scale scores and aesthetic scores. The incidences of fibrosis in the surgical area ( p < 0.001 ) and seroma ( p = 0.02 ) were higher in the VD cohort. Moreover, the AICAP cohort indicated greater satisfaction with breasts ( p = 0.03 ), physical well-being chest ( p = 0.001 ) and aesthetic outcomes ( p < 0.001 ) compared to the VD cohort. After balancing inter-cohort confounding via propensity score matching, the AICAP cohort indicated greater satisfaction with breasts ( p = 0.01 ), sex well being ( p = 0.04 ) and aesthetic outcomes ( p = 0.01 ) compared to the VD cohort. The AICAP cohort had longer durations of surgery ( p = 0.03 ) and more blood loss ( p = 0.02 ) than the VD cohort. In the breast-conserving surgery for lower quadrant cancers, AICAP flap demonstrated higher scores in patient-reported outcomes and aesthetic outcomes compared to VD.