Chest Wall Perforator Flaps in Breast Conservation: Versatile, Affordable, and Scalable: Insights from the Largest Single-Surgeon Audit from India
Chest wall perforator flaps (CWPFs) are a promising option for partial breast reconstruction but are underutilized, particularly in resource-limited settings. This retrospective observational study explores the feasibility and impact of CWPFs in breast-conserving surgery at our single-surgeon center...
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| Format: | Article |
| Language: | English |
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MDPI AG
2025-03-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/32/3/165 |
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| author | C. B. Koppiker Rupa Mishra Vaibhav Jain Priya Sivadasan Chetan Deshmukh Beenu Varghese Upendra Dhar Anushree Vartak Namrata Athavale Neerja Gupta Laleh Busheri Vishesha Lulla Sneha Bhandari Sneha Joshi |
| author_facet | C. B. Koppiker Rupa Mishra Vaibhav Jain Priya Sivadasan Chetan Deshmukh Beenu Varghese Upendra Dhar Anushree Vartak Namrata Athavale Neerja Gupta Laleh Busheri Vishesha Lulla Sneha Bhandari Sneha Joshi |
| author_sort | C. B. Koppiker |
| collection | DOAJ |
| description | Chest wall perforator flaps (CWPFs) are a promising option for partial breast reconstruction but are underutilized, particularly in resource-limited settings. This retrospective observational study explores the feasibility and impact of CWPFs in breast-conserving surgery at our single-surgeon center, where 203 procedures were performed between 2018 and 2023. We evaluate 200 cases treated after multidisciplinary tumor board discussions and shared decision-making, assessing clinicopathological data, surgical outcomes, oncological results, cosmetic outcomes, and patient-reported outcome measures (PROMs). The median age of patients was 52.5 years. Single CWPFs were used in 75.9% and dual flaps in 24.1%. Sentinel node biopsy was performed in 76.9% of malignant cases, with no positive margins. Minor complications occurred in 11%, and no major complications were reported. At a 27-month median follow-up, the overall survival rate was 97.5%, with a disease-free survival of 92.1%. Cosmetic outcomes were good-to-excellent, and PROMs indicated high satisfaction. This largest single-surgeon study from Asia demonstrates the transformative role of CWPFs in breast conservation surgery for Indian women with sizable, locally advanced tumors. The technique offers excellent oncological and cosmetic outcomes, reduced costs, and a shorter operative time, highlighting the need for oncoplastic algorithms in resource-limited settings to improve breast conservation accessibility. |
| format | Article |
| id | doaj-art-6f9b45895c7f49889e9e44789d57d1b2 |
| institution | OA Journals |
| issn | 1198-0052 1718-7729 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj-art-6f9b45895c7f49889e9e44789d57d1b22025-08-20T02:11:25ZengMDPI AGCurrent Oncology1198-00521718-77292025-03-0132316510.3390/curroncol32030165Chest Wall Perforator Flaps in Breast Conservation: Versatile, Affordable, and Scalable: Insights from the Largest Single-Surgeon Audit from IndiaC. B. Koppiker0Rupa Mishra1Vaibhav Jain2Priya Sivadasan3Chetan Deshmukh4Beenu Varghese5Upendra Dhar6Anushree Vartak7Namrata Athavale8Neerja Gupta9Laleh Busheri10Vishesha Lulla11Sneha Bhandari12Sneha Joshi13Prashanti Cancer Care Mission (PCCM), Pune 411016, IndiaPrashanti Cancer Care Mission (PCCM), Pune 411016, IndiaPrashanti Cancer Care Mission (PCCM), Pune 411016, IndiaPrashanti Cancer Care Mission (PCCM), Pune 411016, IndiaOrchids Breast Health Centre, in Association with PCCM and Jehangir Hospital, Pune 411001, IndiaOrchids Breast Health Centre, in Association with PCCM and Jehangir Hospital, Pune 411001, IndiaOrchids Breast Health Centre, in Association with PCCM and Jehangir Hospital, Pune 411001, IndiaInternational School of Oncoplastic Surgery, Pune 411048, IndiaPrashanti Cancer Care Mission (PCCM), Pune 411016, IndiaInternational School of Oncoplastic Surgery, Pune 411048, IndiaPrashanti Cancer Care Mission (PCCM), Pune 411016, IndiaPrashanti Cancer Care Mission (PCCM), Pune 411016, IndiaPrashanti Cancer Care Mission (PCCM), Pune 411016, IndiaPrashanti Cancer Care Mission (PCCM), Pune 411016, IndiaChest wall perforator flaps (CWPFs) are a promising option for partial breast reconstruction but are underutilized, particularly in resource-limited settings. This retrospective observational study explores the feasibility and impact of CWPFs in breast-conserving surgery at our single-surgeon center, where 203 procedures were performed between 2018 and 2023. We evaluate 200 cases treated after multidisciplinary tumor board discussions and shared decision-making, assessing clinicopathological data, surgical outcomes, oncological results, cosmetic outcomes, and patient-reported outcome measures (PROMs). The median age of patients was 52.5 years. Single CWPFs were used in 75.9% and dual flaps in 24.1%. Sentinel node biopsy was performed in 76.9% of malignant cases, with no positive margins. Minor complications occurred in 11%, and no major complications were reported. At a 27-month median follow-up, the overall survival rate was 97.5%, with a disease-free survival of 92.1%. Cosmetic outcomes were good-to-excellent, and PROMs indicated high satisfaction. This largest single-surgeon study from Asia demonstrates the transformative role of CWPFs in breast conservation surgery for Indian women with sizable, locally advanced tumors. The technique offers excellent oncological and cosmetic outcomes, reduced costs, and a shorter operative time, highlighting the need for oncoplastic algorithms in resource-limited settings to improve breast conservation accessibility.https://www.mdpi.com/1718-7729/32/3/165perforator flaponcoplastybreast cancerquality of lifeLMIC |
| spellingShingle | C. B. Koppiker Rupa Mishra Vaibhav Jain Priya Sivadasan Chetan Deshmukh Beenu Varghese Upendra Dhar Anushree Vartak Namrata Athavale Neerja Gupta Laleh Busheri Vishesha Lulla Sneha Bhandari Sneha Joshi Chest Wall Perforator Flaps in Breast Conservation: Versatile, Affordable, and Scalable: Insights from the Largest Single-Surgeon Audit from India Current Oncology perforator flap oncoplasty breast cancer quality of life LMIC |
| title | Chest Wall Perforator Flaps in Breast Conservation: Versatile, Affordable, and Scalable: Insights from the Largest Single-Surgeon Audit from India |
| title_full | Chest Wall Perforator Flaps in Breast Conservation: Versatile, Affordable, and Scalable: Insights from the Largest Single-Surgeon Audit from India |
| title_fullStr | Chest Wall Perforator Flaps in Breast Conservation: Versatile, Affordable, and Scalable: Insights from the Largest Single-Surgeon Audit from India |
| title_full_unstemmed | Chest Wall Perforator Flaps in Breast Conservation: Versatile, Affordable, and Scalable: Insights from the Largest Single-Surgeon Audit from India |
| title_short | Chest Wall Perforator Flaps in Breast Conservation: Versatile, Affordable, and Scalable: Insights from the Largest Single-Surgeon Audit from India |
| title_sort | chest wall perforator flaps in breast conservation versatile affordable and scalable insights from the largest single surgeon audit from india |
| topic | perforator flap oncoplasty breast cancer quality of life LMIC |
| url | https://www.mdpi.com/1718-7729/32/3/165 |
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