Abstract: Objective　To investigate the efficacy and cosmetic effect of immediate breast reconstruction with expanded latissimus dorsi myocutaneous flap after modified radical mastectomy with nipple and areola preserved. Methods　Clinical data of 50 patients with breast cancer from April 2014 to April 2019 were retrospectively analyzed. The operation was modified radical mastectomy with nipple and areola sparing or skin sparing and breast reconstruction with extended latissimus dorsi myocutaneous flap. The operative related indexes (operative time, operative blood loss and drainage tube indwelling time) and postoperative complications were observed, and the postoperative cosmetic effect was evaluated. Results　Modified radical mastectomy and breast reconstruction were successfully completed in 50 patients, and the survival rate of skin flap was 100%. The amount of breast tissue resection was (200±50) g, the operative time was (220±40) min, the operative blood loss was (35±15) mL, the indwelling time of chest drainage tube was (12±4) d, and the indwelling time of back drainage tubewas (20±5) d. Two patients had seroma on the back one month after operation, which disappeared after re-drainage. One patient appeared partial ischemic necrosis of the nipple after operation, which healed after dressing change. One patient had limited upper limb movement, which was relieved after functional exercise. The evaluation of cosmetic effect showed that the excellent and good rate of reconstructed breast was 92%. All patients were followed up for 36-60 months, with a median follow-up of 48 months. No local recurrence or distant metastasis was observed. Conclusion　Breast reconstruction with immediate expanded latissimus dorsi musculocutaneous flap after modified radical mastectomy is suitable for small and medium sized breast of Asian women, with strong operability and good cosmetic effect, and is worthy of clinical promotion.

Key words: Breast tumor, 　Latissimus dorsi myocutaneous, 　Breast reconstruction, 　Cosmetic effect