Marcelo CHÁVEZ-DÍAZ, José Felipe TAPIA AMAYA, Henry Nevin SALAS PAREJAS, Wilfredo Miguel GONZÁLEZ ORTIZ, Carla Carina CEDRÓN LENCI, Gabriel DE LA CRUZ KU, María del Rosario CUEVA PÉREZ
European Journal of Breast Health - 2026;22(4):455-465
Objective: Oncoplastic breast surgery (OBS) allows wide oncologic resections without compromising breast symmetry. In small-breasted patients with minimal ptosis, volume displacement techniques have limited applicability. Lateral intercostal artery perforators (LICAP)-based perforator flaps allow immediate or delayed partial breast reconstruction for lateral and central defects, preserving muscle and minimizing donor-site morbidity. This study aimed to evaluate the safety and outcomes of LICAP-based flaps and to report the first national experience in Peru. Materials and Methods: A retrospective observational study was conducted from August 2023 to August 2025 in patients who underwent OBS with perforator-based flap reconstruction, including LICAP, bilobed LICAP, and combined LICAP-lateral thoracic artery perforator (LTAP) flaps. Results: Twenty patients were included. The mean age was 56.8 years (range, 27-81 years), and 65% were postmenopausal. Indications included invasive ductal carcinoma (85%), ductal carcinoma in situ (5%), and phyllodes tumor (10%). Tumor location: upper outer quadrant (65%), central (20%), upper inner quadrant (10%). Clinical stage IIA was the most frequent (55.5%), and tumors measuring 3-4 cm were observed in 45% of cases. Luminal B was the predominant subtype (40%), and 35% of patients received neoadjuvant chemotherapy. Procedures included bilobed LICAP (35%), LICAP+LTAP (30%), and LICAP (25%). The mean operative time was 134 minutes (range, 90-195 minutes), and the mean pathological tumor size was 3.57 cm (range, 0-7 cm). Negative margins were achieved in 95% of patients. Surgical complications (Clavien-Dindo grade I) occurred in 15%. During a median follow-up of 22.5 months (range, 10-24 months), no locoregional recurrences were observed. Conclusion: LICAP-based volume replacement OBS is a versatile, safe, and reproducible technique that may expand the indications for breast-conserving surgery in selected patients and yields encouraging short-term outcomes comparable to those reported in international series.
