Authors: JeanYves Petit Mario Rietjens Visnu Lohsiriwat Piercarlo Rey Cristina Garusi Francesca De Lorenzi Stefano Martella Andrea Manconi Benedetta Barbieri Krishna B Clough
Publish Date: 2012/03/07
Volume: 36, Issue: 7, Pages: 1486-1497
Abstract
Breast reconstruction is considered as part of the breast cancer treatment when a mastectomy is required Implants or expanders are the most frequent techniques used for the reconstructions Expander provides usually a better symmetry A contralateral mastoplasty often is required to improve the symmetry The nipple areola complex which can be preserved in certain conditions is usually removed and can be reconstructed in a second stage under local anesthesia In case of radical mastectomy and/or radiotherapy a musculocutaneous flap such as rectus abdominis or latissimus dorsi autologous flaps is required When microsurgical facilities are available free or perforator flaps respecting the muscle are preferred to decrease the donor site complications In situ carcinomas or prophylactic mastectomy can be reconstructed immediately as well as invasive carcinoma according to the recent literature Locally advanced breast cancer can be reconstructed after complete oncologic treatment Radiotherapy of the thoracic wall is proposed in case of lymph node metastases raising the discussion about the technique choice and the timing of the reconstruction Plastic surgery procedures can improve the cosmetic results of the conservative surgery also extending its indications and reducing both mastectomy and reexcision rates Oncoplasty techniques are becoming more and more sophisticated requiring the skill of trained plastic surgeons Numerous publications confirm the psychosocial benefit resulting from the breast reconstruction
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