NO DOPPLER CHEST WALL PERFORATOR FLAPS (CWPF) FOR PARTIAL BREAST RECONSTRUCTION: A REPRODUCIBLE TECHNIQUE FROM A HIGH-VOLUME INDIAN CENTER drashutoshmishra11@gmail.com

 

NO DOPPLER CHEST WALL PERFORATOR FLAPS (CWPF) FOR PARTIAL BREAST RECONSTRUCTION: A REPRODUCIBLE TECHNIQUE FROM A HIGH-VOLUME INDIAN CENTER

4

India

Oral or Poster

BCS remains the cornerstone for treating early localized breast cancer. However, achieving oncological clearance alongside optimal cosmetic outcomes is particularly challenging in small- to medium-sized breasts, especially for tumors located in the inner quadrants. Perforator-based oncoplastic flap techniques have gained traction in recent years, yet many require intraoperative Doppler use, specialized training, or complex instrumentation, limiting their widespread adoption.

A total of 137 patients with a minimum of one year follow-up were included. The flaps used included the lateral LICAP, n=67, MICAP, n=18, and AICAP, n=12, all harvested without Doppler guidance. Operative time, ease of flap harvest, postoperative recovery, and aesthetic satisfaction were assessed. Patient-reported outcomes were evaluated using the BREAST-Q™ questionnaire six months after completion of adjuvant radiotherapy.

The average flap harvest and inset times were 41, 23, and 25 minutes for LICAP, MICAP, and AICAP respectively—demonstrating the efficiency and simplicity of the no-Doppler technique. Among the 94 patients who completed radiotherapy, 80 (82.4%) responded to the BREAST-Q™ survey. Highest median scores were seen in satisfaction with the breast surgeon, medical team, and office staff [100 (IQR: 0)], while the lowest was in sexual well-being [72 (IQR: 46)]—highlighting strong patient trust and satisfaction.

No-Doppler chest wall perforator flaps are a safe, quick, and cosmetically satisfying option for partial breast reconstruction. The technique offers a short learning curve, reproducible outcomes, and is feasible even in resource-limited settings such as district hospitals—making it a valuable addition to the breast surgeon’s toolkit across diverse surgical environments.