Surgical approach for ulcerated locally advanced breast cancer. A single Center experience: a retrospective study


COD: 02_2017_03_2615 Categorie: ,

Rita Laforgia, Clelia Punzo, Annunziata Panebianco, Annalisa Volpi, Marina Minafra, Maria Grazia Sederino

Ann. Ital. Chir., 2017 88, 2: 105-109

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AIM: The aim of our retrospective study is to analyze surgical possibilities for the extended LABC in those cases not suitable
for a neoadjuvant chemotherapy step and to consider various reconstruction techniques.
MATERIAL OF STUDY: Between 2009 and 2015 we enrolled 11 patients, admitted to the Emergency Department, presenting
ulcerated LABC that needed palliative surgical demolitive procedures because of bleeding and anemia and in
which was necessary to use natural tissues transposition or synthetic substitutes for the reconstruction of the skin flaps.
RESULTS: The mean follow up was 12 months. Mortality rate was 82% (9 patients); in 2 cases there was local relapse
after 6 months; 9 months was the longest disease free survival.
DISCUSSION: Thanks to multidisciplinary strategies LABC’s surgical treatment improved results with a five-year survival
rate between 30-40% and better quality of survival. Despite extended demolitive approach, there is still a 50% of death
because of metastases.
CONCLUSIONS: Our results confirm that musculocutaneous flap, skin anterior thigh grafts, bilayer matrix wound dressing
are excellent reconstructive strategies in locally advanced ulcerated breast cancer after aggressive extended surgery even
if palliative to improve patients’ further survival. Our data also showed that those patients presenting medium level of