Immediate breast reconstruction in Chinese women using the transverse rectus abdominis myocutaneous (TRAM) flap.

BACKGROUND

Total mastectomy remains the mainstay of operative treatment for breast cancer mainly because it is preferred by surgeons. The techniques and benefits of reconstructing the amputated breast have been well documented in the medical literature but there have been very few reports on this issue in Chinese women. Immediate breast reconstruction using the transverse rectus abdominis myocutaneous (TRAM) flap in Chinese women suffering from early breast cancer who require mastectomy is summarized.

METHODS

Since September 1991, the option of immediate breast reconstruction was offered to all patients less than 60 years of age suffering from early cancer (Tis, T1 or T2) who were not suitable for breast-conserving treatment or who preferred to have a mastectomy. The single-pedicled TRAM flap was used.

RESULTS

From September 1991 to September 1994, 27 reconstructions were performed. Partial flap loss occurred in four patients (15%), fat necrosis in three patients (11%) and abdominal bulging in one patient (4%). Operations performed by two teams simultaneously reduced operating time by 1.5 h without increasing the risk of complications. Twenty-one patients (78%) were satisfied or very satisfied with the outcome of reconstruction.

CONCLUSIONS

The TRAM flap is a satisfactory method of breast reconstruction in Chinese women. A two-team approach can be employed safely to shorten operative time. Overall patient satisfaction was high.