Background and objective.

To obtain good results with autologous latissimus dorsi flap in breast reconstruction it's necessary to verify the presence of adequate thoracodorsal vascularity.

In this paper we evaluate the contribution of Doppler-Duplex ultrasound for the localization of the thoracodorsal vessels prior to delayed breast reconstruction with a dorsal fap.

Methods.

Review of 51 patients with a history of axillary surgery for breast cancer, candidates for delayed breast reconstruction with an ipsilateral flap of the latissimus dorsi muscle. The ultrasound examination was performed by a single radiologist using the Doppler-Duplex ultrasound modality.

Results.

Among the 51 patients, the thoracodorsal artery was located by ultrasound in 39 cases (76.47%). In 12 cases it could not be located or its identification was doubtful. Among these 12 cases, 8 underwent computed tomography angiography or magnetic resonance angiography, which identified the artery in 5 cases. In the remaining 3 cases the patients refused such examinations and did not undergo reconstruction.

Confirmed data are available in 47 cases, among which thoracodorsal vasculature was not visualized in 3 cases, which represents 6.38%,

The resulting diagnostic parameters were: sensitivity 88.63%; specificity 100%; positive predictive value 100%; and negative predictive value 37.50%, with an accuracy of 89.36%.

Conclusions.

From our experience we can conclude that,when the appropriate experience and equipment are available, Doppler-Duplex ultrasound should be the first procedure to be used for the evaluation of the thoracodorsal vasculature. And in the case of not meeting these requirements or the ultrasound was doubtful/negative, perform other methods such as computed tomography angiography or magnetic resonance angiography.

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