Reconstruction of a Partial Mastectomy Defect with the Superficial Inferior Epigastric Artery (SIEA) Flap

A case in which a superficial inferior epigastric artery (SIEA) flap was used to reconstruct a partial mastectomy defect is described. The SIEA vessels have been shown to be predictable and to match well with the recipient internal mammary vessels. In addition, this flap does not require opening of the anterior rectus sheath, and it is possible to design a smaller flap, which would allow closure at the donor site without translocation of the umbilicus. The risk of developing an abdominal hernia or bulge is therefore nonexistent, and a very low and more inconspicuous scar is produced, both of which are advantages for the patient.

KEYWORDS

Superficial inferior epigastric artery (SIEA) flap - partial mastectomy defect reconstruction - breast reconstruction

REFERENCES

• 1 Sarrazin D, Le M, Rouesse J et al.. Conservative treatment versus mastectomy in breast cancer tumors with macroscopic diameter of 20 millimeters or less.  Cancer. 1984;  53 1209-1213
• 2 Fisher B, Redman C, Poisson R et al.. Eight-year results of a randomized clinical trial comparing total mastectomy and lumpectomy with or without irradiation in the treatment of breast cancer.  N Engl J Med. 1989;  320 822-828
• 3 Veronesi U, Salvadori S, Luina A et al.. Conservative treatment of early breast cancer.  Ann Surg. 1990;  211 250-259
• 4 Amichetti M, Busana L, Caffo O. Long-term cosmetic outcome and toxicity in patients treated with quadrantectomy and radiation therapy for early-stage breast cancer.  Oncology. 1995;  52 177-181
• 5 Rose M A, Olivotto I A, Cady B et al.. Conservative surgery and radiation therapy for early breast cancer. Long-term cosmetic results.  Arch Surg. 1989;  124 153-157
• 6 Calais G, Berger C, Descamps P et al.. Conservative treatment feasibility with chemotherapy, surgery, and radiotherapy for patients with breast carcinoma larger than 3 cm.  Cancer. 1984;  74 1283-1288
• 7 Scholl S M, Fourquet A, Asselain B et al.. Neoadjuvant versus adjuvant chemotherapy in premenopausal patients with tumours considered too large for breast conserving surgery: preliminary results of a randomised trial: S6.  Eur J Cancer. 1994;  30 645-652
• 8 Clough K B, Cuminet J, Fitoussi A et al.. Cosmetic sequelae after conservative treatment for breast cancer: classification and results of surgical correction.  Ann Plast Surg. 1998;  41 471-481
• 9 Corral C J, Mustoe T A. Controversy in breast reconstruction.  Surg Clin North Am. 1996;  76 309-326
• 10 Losken A, Elwood E T, Styblo T M, Bostwick J. The role of reduction mammaplasty in reconstructing partial mastectomy defects.  Plast Reconstr Surg. 2002;  109 968-975
• 11 Clough K B, Kroll S S, Audretsch W. An approach to the repair of partial mastectomy defects.  Plast Reconstr Surg. 1999;  104 409-420
• 12 Kat C C, Darcy C M, O'Donoghue J M, Taylor A R, Regan P J. The use of the latissimus dorsi musculocutaneous flap for immediate correction of the deformity resulting from breast conservation surgery.  Br J Plast Surg. 1999;  52 99-103
• 13 Moran S L, Serletti J M, Fox I. Immediate free TRAM reconstruction in lumpectomy and radiation failure patients.  Plast Reconstr Surg. 2000;  106 1527-1531
• 14 Mizgala C L, Hartrampf C R, Bennet G K. Assessment of the abdominal wall after pedicled TRAM flap surgery: 5 to 7 year follow-up of 150 consecutive patients.  Plast Reconstr Surg. 1994;  93 988-1002
• 15 Allen R J, Heitland A S. Superficial inferior epigastric artery flap for breast reconstruction.  Seminars Plast Surg. 2002;  16 35-43
• 16 Allen R. The superficial inferior epigastric artery flap: an anatomic and clinical study for use in reconstruction of the breast. In the Proceedings of the Xth Annual Meeting of the Southeastern Society of Plastic and Reconstructive Surgeons Kiawah, SC; June 3-7, 1990