关键词: 局部晚期, 乳腺癌, 腹直肌肌皮瓣, 背阔肌肌皮瓣, 胸壁缺损

Abstract:

Objective The value of radical resection of locally advanced breast cancer combined with flap transfer in the repair of chest wall defects. Method The clinical data of 15 patients with locally advanced breast cancer at stage Ⅲ B and Ⅲ C treated in Shandong Provincial Hospital Affiliated to Shandong First Medical University from January 2018 to June 2023 were retrospectively studied. The patients were treated by multiple means before operation. After the local lesions were controlled, the patients were treated with radical operation of breast cancer. At the same time, the rectus abdominis or latissimus dorsi myocutaneous flap was used to repair the chest wall defect. Summarize and analyze the basic situation, treatment and follow-up of patients. Result As of January 2025, 8 of the 15 patients survived and 7 died. The overall survival time was 1036d (280 ～ 2237d). The pathological subtypes of 15 patients included luminal type A (3 cases), luminal type B (4 cases), human epidermal growth factor receptor 2 positive breast cancer (5 cases) and triple negative breast cancer (3 cases). 14 cases received preoperative chemotherapy, 4 cases received preoperative targeted therapy, and 5 cases received preoperative interventional therapy. Latissimus dorsi myocutaneous flap was used in 5 cases and rectus abdominis myocutaneous flap in 10 cases. Recurrence occurred in 3 cases. The survival time was 1423 d (372 ～ 1498d); The survival time was 985.5d (280 ～ 2237d). Conclusion The comprehensive treatment mode combined with pedicled myocutaneous flap repair technology is helpful to control the lesions and improve the quality of life of patients with locally advanced breast cancer.

Key words: Locally advanced, Breast cancer, Rectus abdominis myocutaneous flap, Latissimus dorsimyocutaneous flap, Chest wall defect