Objective: To assess the application efficacy of using incision of the fascia over the serratus anterior muscle on the inferolateral border of the pectoralis major muscle for silicone prosthesis breast reconstruction.
Methods: The clinical data of 124 patients with breast cancer undergoing total mastectomy and prosthesis implantation for breast reconstruction from February 2014 to January 2015 were reviewed. Of the patients,
23 cases underwent traditional modified radical mastectomy, 22 cases underwent skin sparing total mastectomy, and 79 cases underwent nipple sparing total mastectomy. All patients received breast reconstruction with silicone prosthesis though incision of fascia over the serratus anterior muscle on the inferolateral border of pectoralis major muscle. The surgical variables, postoperative results, complications and long-term outcomes were analyzed.
Results: Operation was successfully completed in all the 124 patients. The operative time was 65–120 min, with an average of (83.62±14.18) min, and the intraoperative blood loss was 45–105 mL, with an average of (78.14±17.47) mL. After operation, the excellent/good rate of the appearance evaluation for the reconstructed breast was 82.25% (102/124). Seroma occurred in 7 patients, which was relieved after drainage; incision dehiscence was observed in 5 cases and was resolved by anti-inflammatory treatment, dressing change and resuture; prosthesis removal was required in none of the patients. Followed-up was performed for 22 to
50 months, and 9 patients were lost to follow-up, all of whom had disease free survival before lost to follow-up. During follow-up, 5 patients developed bone metastases, pulmonary metastases and liver metastases occurred in one case each, and no local recurrence was found in any of them.
Conclusion: Using incision of the fascia over the serratus anterior muscle on the inferolateral border of the pectoralis major muscle for silicone prosthesis breast reconstruction is safe, effective and easy to be performed, and is recommended to be widely adopted.