Objective To investigate the feasibility and aesthetic effect of pedicled internal mammary artery perforator (IMAP) flap for repairing local defect of breast-conserving surgery in lower quadrant.

Methods Clinical data of 12 patients with breast cancer admitted to the First People's Hospital of Chenzhou from February 2018 to February 2021 were retrospectively analyzed. The tumors were all located in the lower inner quadrant. Pedicled IMAP flap was used to repair local defects after breast-conserving surgery, and the anatomy of each perforator vessel was recorded. The operative indicators (time of flap making, amount of focal tissue resected, operative time and secondary expansion rate of resection margin) and postoperative complications were observed, and the postoperative cosmetic effect was evaluated.

Results All 12 patients underwent breast-conserving surgery successfully. The perforating vessels of internal mammary artery were found to be relatively constant, and the average time of making flap was (12±2) min. The average intraoperative amount of lesion tissue was (98.0±16.5) g, the average operative time was (105±15) min, and the secondary expansion rate of edge was 16.7%. There were 1 case of necrosis at the tip of the flap and 1 case of liquefaction of subcutaneous fat. Both healed after drug change. The remaining 10 cases healed at the first stage. The incidence of postoperative complications was 16.7%. The rate of excellent and good of postoperative cosmetic effect evaluation was 91.7%. The mean follow-up time was 36 months. No local recurrence was found, and only 1 case had bone metastasis.

Conclusions Pedicled IMAP flap can repair the local defect after breast-conserving surgery in the lower quadrant of the breast cancer, which has strong operability, little trauma and good cosmetic effect, and is worthy of clinical promotion.