In mastectomy women an immediate breast reconstruction has become a real option over the past several years. Like many other reconstructive procedures, breast reconstruction aims not only to restore body form and anatomy, but also to improve quality of life and emotional well-being. The aim of the study was to review the cases of mastectomies and immediate breast reconstructions within 8 years and propose a mastectomy-reconstructive protocol to be used and evaluated for the future. Material and methods. Since January 2001, 39 patients of average age 43.9 years underwent mastectomy for early breast cancer and subsequent immediate reconstruction. Patients had either the breast reconstructed with an abdominal flap at the time of mastectomy, or they had a two stage reconstruction with the expander placed during mastectomy procedure and subsequent silicone-gel implant placement. The retrospective chart review of the records of patients with diagnosis of breast cancer were reviewed for histology, tumor size and technique of reconstruction used. Based on the pictures of postoperative results and the chart review, the reconstructive protocol was proposed. Results. The number of patients having immediate reconstruction has significantly increased over the past three years compare to previous period form 2001 till 2005. Majority of the patients were treated for early breast cancers (DCIS - ductal carcinoma in situ or invasive cancer smaller than 2 cm). The vital tissue was used for the reconstruction in 27 patients(71%). Silicone gel implant/implants were used for reconstruction in 11(29%) patients. 23 reconstructions was bilateral for the diagnosis of high oncological risk of contralateral breast parenchyma. Best results were achieved in patients with bilateral breast reconstructions having skin sparing or nipple sparing mastectomy and not having postmastectomy radiation therapy. Conclusions. The immediate breast reconstruction seems to be a reasonable solution for many patients having mastectomy for early breast cancer, smaller than 2 cm and negative sentinel node biopsy (low risk for postmastectomy radiation therapy). We prefer skin sparing or nipple sparing mastectomy if possible. The reconstruction with abdominal tissue results in a good and time-stable results in majority of the cases.
- Breast cancer
- DIEP flap
- Immediate breast reconstruction
- TRAM flap