Abstract

BACKGROUND: Breast cancer is the most frequent cancer among women. Different surgical techniques are being used for management of breast cancer whether CBS or mastectomy. More than half of women diagnosed with breast cancer undergo mastectomy whether as a primary surgical procedure or as a completion mastectomy Dog ear at the lateral end of mastectomy scar can cause poor cosmetic results, and discomfort so; there are many techniques to prevent its formation as the best method for treatment of dog ear after mastectomy is avoidance of its occurrence. This study aimed to compare the triangular advancement flap technique with the fish-tail plasty technique regarding the feasibility of the technique, avoidance of dog ear deformity formation at the lateral end of mastectomy scar, surgeons’ satisfaction and patient’s satisfaction and comfrtability. PATIENTS AND METHODS: This study included sixty obese and/or large- breasted female patients with breast cancer scheduled for MRM. Patients were randomly allocated into two groups: Group I included thirty patients underwent fish-tail plasty technique and Group II included thirty patients who underwent triangular advancement flap technique. Patients were followed up for the incidence of dog ear deformity, surgeon satisfaction and patient’s satisfaction and comfortability. RESULTS: Both techniques were feasible in performance with good exposure of axilla and good achievement of patient’s comfortability. The triangular advancement flap technique was associated with lower incidence of dog ear, fewer wound complications and shorter operative time but it had a longer scar length. Patients and surgeons satisfaction were significantly more satisfied in G II in comparison to G I (P= 0.001 and 0.015 respectively). CONCLUSION: Triangular advancement flap technique is effective, feasible technique for prevention of dog ear at the lateral end of mastectomy scar with lower incidence rate of dog ear formation, shorter operative time, lower incidence of flap necrosis and wound dehiscence and better patients and surgeons satisfaction when compared with fish-tail plasty technique.