Breast reconstruction is available today to almost any woman undergoing total or partial mastectomy for breast cancer. Several methods are available for reconstructing the breast either at the same time as breast cancer surgery (immediate reconstruction) or months or even years later, when the patient chooses (delayed reconstruction). A new breast mound can be reconstructed using autologous soft tissues from the abdomen, back, or buttock or by using a prosthetic implant. Immediate reconstruction generally results in a better cosmetic outcome than does delayed reconstruction. Autologous tissuebased reconstruction, especially when it is performed using flaps of lower abdominal skin and fat, generally produces more natural-looking, more natural-feeling, and longer-lasting breasts than does implant-based reconstruction. The skin-sparing approach to mastectomy has facilitated immediate breast reconstruction and resulted in improved cosmetic outcomes without increased risk of recurrence. Radiation therapy after reconstruction can adversely affect the cosmetic outcome of breast reconstruction, and chemotherapy can delay completion of breast reconstruction; thus, careful preoperative planning is essential to ensure the best cosmetic outcome.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Alderman AK, Wei Y, Birkmeyer JD. Use of breast reconstruction after mastectomy following the Women’s Health and Cancer Rights Act. JAMA 2006;295:387–388.
Allen RJ, Treece P. Deep inferior epigastric perforator flap for breast reconstruction. Ann Plast Surg 1994;32:32–38.
Bajaj AK, Chevray PM, Chang DW. Comparison of donor-site complications and functional outcomes in free muscle-sparing TRAM flap and free DIEP flap breast reconstruction. Plast Reconstr Surg 2006;117:737–746.
Blondeel PN. One hundred free DIEP flap breast reconstructions: a personal experience. Br J Plast Surg 1999;52:104–111.
Bondurant S, Ernster V, Herdman R, eds. Safety of Silicone Breast Implants. Committee on the Safety of Silicone Breast Implants, Division of Health Promotion and Disease Prevention, Institute of Medicine. Washington, DC: National Academy Press; 1999.
Chang DW, Youssef A, Cha S, et al. Autologous breast reconstruction with the extended latissimus dorsi flap. Plast Reconstr Surg 2002;110:751–759.
Chevray PM. Breast reconstruction with superficial inferior epigastric artery (SIEA) flaps: a prospective comparison with TRAM and DIEP flaps. Plast Reconstr Surg 2004;114:1077–1083.
Dean C, Chetty U, Forrest AP. Effects of immediate breast reconstruction on psychosocial morbidity after mastectomy. Lancet 1983;1(8322):459–462.
Gabriel, SE, Woods, JE, O’Fallon, M, et al. Complications leading to surgery after breast implantation. N Engl J Med 1997;336:677–682.
Hartrampf CR, Scheflan M, Black PW. Breast reconstruction with a transverse abdominal island flap. Plast Reconstr Surg 1982;69:216–224.
Hartrampf CR Jr, Noel RT, Drazan L, et al. Ruben’s fat pad for breast reconstruction: a peri-iliac soft-tissue free flap. Plast Reconstr Surg 1994;93:402–407.
Khoo A, Kroll SS, Reece G, et al. A comparison of resource costs of immediate and delayed breast reconstruction. Plast Reconstr Surg 1998;101:964–968.
Kroll SS, Ames F, Singletary SE, et al. The oncologic risks of skin preservation at mastectomy when combined with immediate reconstruction of the breast. Surg Gynecol Obstet 1991;172:17–20.
Kroll SS, Baldwin B. A comparison of outcomes using three different methods of breast reconstruction. Plast Reconstr Surg 1992;90:455–462.
Kroll SS, Evans GRD, Reece GP, et al. Comparison of resource costs between implant-based and TRAM flap breast reconstruction. Plast Reconstr Surg 1996;97:364–372.
Kroll S, Khoo A, Singletary S, et al. Local recurrence risk after skin-sparing and conventional mastectomy: a six-year follow-up. Plast Reconstr Surg 1999;104:421–425.
Kronowitz SL, Feledy JA, Hunt KK, et al. Determining the optimal approach to breast reconstruction after partial mastectomy. Plast Reconstr Surg 2006a;117:1–11.
Kronowitz SL, Kuerer HM, Hunt KK, et al. Impact of sentinel lymph node biopsy on the evolution of breast reconstruction. Plast Reconstr Surg 2006b;118:1089–1099.
Kronowitz SL, Robb GL. Breast reconstruction with postmastectomy radiation therapy: Current issues. Plast Reconstr Surg 2004;114:950–960.
Motwani SB, Strom EA, Schechter NR, et al. The impact of immediate breast reconstruction on the technical delivery of postmastectomy radiotherapy. Int J Radiat Oncol Biol Phys 2006;66:76–82.
Newman L, Kuerer H, Hunt K, et al. Feasibility of immediate breast reconstruction for locally advanced breast cancer. Ann Surg Oncol 1999;6:671–675.
Newman LA, Kuerer HM, Hunt KK, et al. Presentation, treatment, and outcome of local recurrence after skin-sparing mastectomy and immediate breast reconstruction. Ann Surg Oncol 1998;5:571–572.
Peters W, Pritzker K, Smith D, et al. Capsular calcification associated with silicone breast implants: incidence, determinants, and characterization. Ann Plast Surg 1998;41:348–360.
Plastic Surgery Information Service. National Clearing House of Plastic Surgery Statistics. 2005. http://www.plasticsurgery.org/public_education/2004 Statistics.cfm. Accessed February 8, 2006.
Robb GL, Miller MJ. Muscle harvest. In: Ramirez D, Daniel RK, eds. Endoscopic Plastic Surgery. New York: Springer-Verlag; 1995.
Schover LR, Yetman RJ, Tuason LJ, et al. Partial mastectomy and breast reconstruction. A comparison of their effects on psychosocial adjustment, body image, and sexuality. Cancer 1995;75:54–64.
Shaw W, Ahn C. Free flap breast reconstruction. In: Habal M, ed. Advances in Plastic and Reconstructive Surgery. Vol 9. St. Louis: Mosby Year Book; 1993:221–241.
Singletary SE. Skin-sparing mastectomy with immediate breast reconstruction: the M. D. Anderson Cancer Center experience. Ann Surg Oncol 1996;3:411–416.
Toth BA, Lappert P. Modified skin incisions for mastectomy: the need for plastic surgical input in preoperative planning. Plast Reconstr Surg 1991;87:1048–1053.
Tran NV, Evans GRD, Kroll SS, et al. Postoperative adjuvant irradiation: effects on transverse rectus abdominis muscle flap breast reconstruction. Plast Reconstr Surg 2000;106:313–317.
Tran NV, Chang DW, Gupta A, et al. Comparison of immediate and delayed free TRAM flap breast reconstruction in patients receiving postmastectomy radiation therapy. Plast Reconstr Surg 2001;108:78–82.
Womens Health and Cancer Rights Act (WHCRA). 1998, United States code, title 29, chapter 18, subchapter I, subtitle B, part 7, subpart B, §1185b, available at: http://www.cms.hhs.gov/HealthInsReformforConsume/06_TheWomen’sHealthandCancer RightsAct.asp. Accessed April 16, 2007.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2008 Springer Science + Business Media, LLC
About this chapter
Cite this chapter
Chevray, P.M., Robb, G.L. (2008). Breast Reconstruction. In: Hunt, K.K., Robb, G.L., Strom, E.A., Ueno, N.T. (eds) Breast Cancer 2nd edition. M.D. Anderson Cancer Care Series. Springer, New York, NY. https://doi.org/10.1007/978-0-387-34952-7_8
Download citation
DOI: https://doi.org/10.1007/978-0-387-34952-7_8
Publisher Name: Springer, New York, NY
Print ISBN: 978-0-387-34950-3
Online ISBN: 978-0-387-34952-7
eBook Packages: MedicineMedicine (R0)