Patient Satisfaction Higher With Certain Breast Reconstruction Techniques

The chest wall perforator flap technique is becoming more common for breast cancer reconstruction surgeries, and new findings established higher patient satisfaction with the technique within a 21-month follow-up compared with other methods, according to a recent study published in Surgery reported.1

Breast reconstruction usually occurs after an individual has undergone a mastectomy, where the entire breast is removed, or a lumpectomy, where only the cancer cells and a small piece of healthy breast tissue are removed. There are 2 main types of breast reconstruction: implant reconstruction and tissue (flap) reconstruction, which are sometimes used in conjunction to rebuild a woman’s breast entirely. Reconstruction can take place directly after a mastectomy or lumpectomy, or it can happen months or even years later to one or both breasts.2 The study aimed to assess the safety and complication profile of different standard breast reconstruction techniques.1

Patient satisfaction was higher amongst women who underwent chest wall perforator flap technique when compared with other techniques.| Image Credit: AdobeStock_ H_Ko.jpeg

Breast-conserving surgeries and techniques provide psychological and aesthetic benefits for patients, thus translating to improved quality of life, making them the most preferred choice of treatment for individuals with breast cancer.1

The retrospective comparative observational study included 346 female participants who underwent breast cancer surgery between December 2020 and September 2024. The average age was 59.58 years, and the mean body mass index ranged from 20 to 36.7. Amongst the subtypes of breast cancer present in participants, the most common was invasive ductal carcinoma (IDC, 75%), followed by ductal carcinoma in situ (DCIS, 19.4%) and invasive lobular carcinoma (ILC, 8.3%).

Patients were then divided into variants depending on the type of breast cancer surgery they underwent and whether or not they opted for immediate reconstruction or no reconstruction at all. Of them, 36 underwent chest wall perforator flap reconstruction, which moves a patient’s skin and fat, but not muscle, from the chest area to reconstruct the breast using a perforator (blood vessels) for blood supply. The remaining groups included those who received a lumpectomy without reshaping (n = 161), a lumpectomy with oncoplastic mammoplasty (breast conservation with plastic surgery techniques; n = 69), and a mastectomy with or without immediate reconstruction (n = 80).

In addition to the complication rates of each operation, including re-excision (a follow-up procedure to remove additional tissue), local recurrence of cancer cells, and patient satisfaction, measured using the BREAST-Q assessment. The complication rate in patients who underwent the chest wall perforator flap was 11.1%, similar to that of the lumpectomy (11.8%) and the oncoplastic mammoplasty (11.6%), which is significantly lower when compared with mastectomy with reconstruction (23.1%). The re-excision rate in the chest wall with perforator flap (13.9%) was also significantly lower compared with the lumpectomy (19.3%) and the oncoplastic cases (17.4%). Furthermore, there were no local or distant recurrences observed with the chest wall perforator flap in patients with an average follow-up of 21.4 months; patient satisfaction was also high with this procedure, with 86.1% reporting favorable outcomes.

Researchers concluded, “In cases involving the removal of more than 20% of the breast volume, tumors located in areas of the breast with less tissue, which are more difficult to remodel, or in patients who do not accept contralateral breast symmetrization, volume replacement techniques with chest wall perforator flaps (CWPFs) have been postulated as an interesting option to preserve the breast while achieving a good cosmetic result.”

References

1. Acera M, García EC, Román CFS, et al. Breast reconstruction techniques with perforator flaps vs other surgical techniques in breast cancer. Surgery. Published online August 6, 2025. doi:10.1016/j.surg.2025.109586

2. Breast reconstruction: What is it, types, procedure & recovery. Cleveland Clinic. June 30, 2025. Accessed August 8, 2025. https://my.clevelandclinic.org/health/treatments/16809-breast-reconstruction.