To explore the application of autologous breast reconstruction in the repair of chest wall defects in patients with breast phyllodes tumor after surgery.

In this study, we analyzed the clinical data of seven patients with breast phyllodes tumor in the Affiliated Hospital of Guizhou Medical University and Hunan Cancer Hospital in 2016-2022. Among them, four patients had giant phyllodes tumors, and three patients showed a high tumor-to-breast volume ratio. All patients underwent primary autologous breast reconstruction after mastectomy, of which three cases received deep inferior epigastric perforator flap (DIEP) transpaltation and four cases received pedicled transverse rectus abdominis musculocutaneous flap (TRAM) transfer. The operation time, blood loss and postoperative complications of all patients were recorded. A self-designed scale was used to evaluate the cosmetic effect of the breast at 3 months after surgery.

The median operation time of all patients was 417 minutes and the median blood loss was 41 ml. Postoperative pathological results showed that four patients had malignant phyllodes tumors (one case underwent DIEP transplantation and three cases underwent TRAM transfer), and three patients had borderline phyllodes tumors (two cases underwent DIEP transplantation, and one case underwent TRAM transfer. All the flaps survived, with good wound repair effect in the surgical area. There were no complications such as infection, rupture of incision and abdominal wall hernia. Until June 2022, they were followed up for 11-77 months (median 41 months). All patients survived, with no recurrence or metastasis. The score for cosmetic effect of the breast was 6 in 4 cases, 5 in 2 cases and 4 in 1 case at 3 months after surgery.

Surgery is effective treatment for patients with breast hyllodestumors. Autologous breast reconstruction by DIEP or TRAM flaps shows good effect on the repair of chest wall defects after tumor resection, which is feasible for giant phyllodes tumors unsuitable for suture in situ after surgery.