Occult malignancy rate associated with thoracodorsal vessel dissection for free flap breast reconstruction.

Background The rate of breast reconstruction following mastectomy is increasing, and currently sits at about 15%. Free flap reconstruction techniques using the thoracodorsal vessels as recipients provide an opportunity for a “second look” at the axillary nodal basin post-mastectomy. The purpose of this study was to determine the occult malignancy rate associated with free flap breast reconstruction. Methods A retrospective chart review was performed to ascertain the occult malignancy rate of women who received a delayed free flap reconstruction at our institution between 1990 and 2001. Any additional therapy as a result of a positive result was also recorded. Results Free flap breast reconstructions between 1990 and 2001 totalled 322, and of those 136 reconstructions were delayed and met our inclusion criteria. An occult malignancy rate of 3.6% (five patients) was identified for these patients. Four patients received additional therapy as a result of this finding. Conclusion This study serves to alert reconstructive surgeons to the potential for finding occult tumour during free flap breast reconstruction. J. Surg. Oncol. 2008;98:94–96. © 2008 Wiley-Liss, Inc.