Volume-replacement oncoplastic surgery using chest wall perforator flaps without Doppler mapping: surgical and patient-reported outcomes from a high-volume tertiary cancer centre in India

Abstract

. Abstract Background: Oncoplastic breast surgery seeks to preserve aesthetic outcomes without compromising oncological safety. Various flap techniques based on tumour location exist, yet limited evidence exists evaluating perforator-based oncoplastic breast reconstruction. This study evaluates surgical and patient-reported outcomes of partial breast reconstruction using chest wall perforator flaps (CWPFs) without Doppler assistance. Methods: The study included 137 patients who underwent CWPFs post-January 2020 and completed 1 year of follow-up before April 2025. Data were analysed from a prospectively maintained database, recording demographics, perioperative events and surgical outcomes. Patient satisfaction was assessed with the BREAST-Q TM questionnaire six months after radiotherapy completion. Results: The mean age of the study population was 48.1 years. Lateral intercostal artery perforator, medial intercostal artery perforator and anterior intercostal artery perforator were performed in 59.1%, 28.5%, and 12.4%, respectively. Mean operative time for flap