Abdominal Flap Provides Improved Breast Reconstruction Results

A new study shows that using the abdominal deep inferior epigastric perforator (DIEP) flap for breast reconstruction following mastectomy provides long-term quality of life (QOL), similar to that of women without breast cancer.

Researchers at Georges Pompidou European Hospital (Paris, France) conducted a cross-sectional study of QOL in women who underwent DIEP flap breast reconstruction between 1995 and 2007, using the Medical Outcomes Study 36-Item Health Survey (Short Form-36), comparing the results to two reference samples, the first of which included 3,308 subjects from the French general population, while the second included 205 French cancer survivors who underwent mastectomy with (70 women ) or without (135 women ) breast reconstruction.

The results showed that women who underwent DIEP flap reconstruction showed QOL scores similar to those for women in the general population. When compared to women who underwent mastectomy, QOL scores were significantly better with DIEP flap reconstruction, with higher scores in all areas of QOL, compared to those with no breast reconstruction, and on five out of eight subscales compared to those with other types of reconstruction. The study was published in the May 2016 issue of Plastic and Reconstructive Surgery.

“These results indicate that DIEP flap breast reconstruction allows patients with breast cancer to maintain a good postoperative quality of life, comparable to that of the general population,” concluded lead author Vincent Hunsinger, MD, and colleagues. “Undergoing breast reconstruction may enhance women's ability to fight against the burden of breast cancer, particularly in younger age groups.”

DIEP flap breast reconstruction involves removal of the deep inferior epigastric perforators blood vessels--including the skin and fat connected to them--from the lower abdomen. The collective flap is then transplanted and connected to the patient's chest using microsurgery. The plastic surgeon then shapes the flap to create the new breast, without the sacrifice of any of the abdominal muscles. Many women who undergo this form of reconstruction enjoy the added benefit of a flatter abdomen. Due to the complexity of the surgery, few breast centers offer DIEP flap breast reconstruction.

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Georges Pompidou European Hospital