Immediate latissimus dorsi miniflap volume replacement for partial mastectomy: use of intra-operative frozen sections to confirm negative margins

Abstract 

Background

Latissimus dorsi (LD) miniflap volume replacement is used for immediate reconstruction after partial mastectomy. This prospectively collected series was analyzed to evaluate the accuracy of intraoperative frozen sections.

Methods

After partial mastectomy, “bed biopsies” were submitted for intraoperative frozen-section analysis. If disease free, volume replacement was undertaken; if involved, targeted re-excisions were taken. Demographic, pathological, and outcome data were recorded. The proportion of breast excised was calculated. Local recurrences were recorded.

Results

One hundred ten partial mastectomies with LD miniflap volume replacement were completed. The median proportion of breast excised was 28% (maximum 72%); median weight 207 g. Frozen sections were positive in 33% of patients with a sensitivity of 83% and accuracy of 96% when compared with paraffin sections. Local recurrence occurred in one case. The median follow-up was 41.4 months.

Conclusions

LD miniflap volume replacement extends the role of breast-conserving surgery. Frozen-section analysis of bed biopsies facilitates a single-stage procedure.

Keywords: Latissimus dorsi, Miniflap, Frozen section, Volume replacement, Partial mastectomy