Role of Chest Wall Perforator Flaps in Breast Surgery: Military Cancer Centre Experience

Abstract

Objective Chest wall perforator flaps (CWPFs) are a muscle-sparing alternative in oncoplastic breast surgery (OPBS). CWPFs offer favourable cosmetic and surgical outcomes while minimising donor-site morbidity. Despite their increasing global adoption, there is a paucity of data from the Middle East and North Africa (MENA) region. This retrospective, descriptive case series aimed to assess our institutional experience with CWPFs, emphasising their feasibility, versatility, and surgical and cosmetic results in breast surgery. Materials and Methods This retrospective case series included all patients who underwent CWPF-based OPBS at the Military Cancer Centre between December 2017 and January 2025. Data on patient demographics, tumour characteristics, surgical indications, flap types and techniques, complications, and patient satisfaction were collected. Results CWPF procedures were performed on 69 patients. The most popular flap type (78.3%) was the lateral intercostal artery flap. Indications included volume replacement (84.1%), implant coverage (4.3%), implant salvage (2.9%), wound closure (7.2%), and deformity correction (1.4%). Most flaps were intended to be turnover flaps (75.4%) rather than propeller flaps (24.6%). No flap loss was noted; the complication rates were low, and the re-excision rate was 0%. Over 85% of patients reported good-to-excellent satisfaction with cosmetic outcomes. Conclusion CWPFs are reliable and versatile techniques in breast-conserving surgery and OPBS, serving as a surgical solution for various reconstructive indications. The findings from this study emphasise the need for broader adoption of CWPFs in Jordan and the MENA region and demonstrate the effective use of CWPFs at a national centre in Jordan.