Immediate Breast Reconstruction in Pregnancy and Lactation
It is estimated that 3% of all breast cancers may be diagnosed in pregnant women, and its incidence is expected to increase due to postpone childbearing. Management of this condition represents a challenge because, in contrast to other areas on breast oncology, there are no large randomized trials to guide surgical and clinical practice. Breast reconstruction can be performed following a specific model designed in our Breast Unit since 2008, where these patients are divided in three distinct groups: first trimester, immediate reconstruction in one-step surgery with breast implants and contralateral symmetry with breast reduction or mastopexy or two-step surgery with temporary expanders; second and third trimester, temporary expanders; and lactation, temporary expanders, autologous flaps, or breast-conserving therapy. If the lactation had ceased at least 3 months ago, it is possible to perform one-step surgery with definitive implant and contralateral breast symmetry. In this situation, an approach with a breast conservative surgery is possible too. With this reconstructive approach, it is possible to minimize the effects of mastectomy in this group of patients. It is a transversal model, which considers all aspects: oncologic, obstetric, and reconstructive.
KeywordsBreast cancer Oncoplastic surgery Breast reconstruction Pregnancy
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