Breast reconstruction after mastectomy

Czech version

Authors: Ondřej Měšťák; Martin Molitor; Jan Měšťák
Authors‘ workplace: Klinika plastické chirurgie 1. LF UK a Nemocnice Na Bulovce, Praha, přednosta doc. MUDr. Jan Měšťák, CSc.
Published in: Prakt Gyn 2015; 19(1): 13-18
Category: Oncogynecology: Review Article

Overview

Breast reconstruction is perceived today as a final stage of breast cancer treatment. It follows the most important phase of treatment, which saves patient’s life. It should never interfere with breast cancer treatment. The result of a breast reconstruction depends significantly on condition of tissues in an area after mastectomy, whether the patient underwent radiotherapy and a willingness of the patient to undergo different demanding procedures. According to timing, we divide breast reconstructions to immediate and delayed. Delayed reconstructions are performed generally at least six months following mastectomy. Use of breast implant for breast reconstruction belongs to least demanding techniques. Time of the procedure and recovery is usually shorter then other types of operations. Reconstruction using autologous tissue most frequently uses a flap consisted of skin and subcutaneous tissue moved to the chest wall for creating volume and shape of a new breast. Other operations intended to achieved symmetry and recreate areola with mammilla follow the creating of volume and shape of the breast.

Key words:
breast cancer – breast reconstruction – mastectomy – mastopexis

Sources

1. Serletti JM, Fosnot J, Nelson JA et al. Breast reconstruction after breast cancer. Plast Reconstr Surg 2011; 127(6): 124e–135e. Dostupné z DOI: <http:// doi: 10.1097/PRS.0b013e318213a2e6>.

2. Slezak S. An evidence-based approach to breast reconstruction. Plast Reconstr Surg 2010; 126(6): 2177–2183.

3. Hernanz F, Sánchez S, Cerdeira MP et al. Long-term results of breast conservation and immediate volume replacement with myocutaneous latissimus dorsi flap. World J Surg Oncol 2011; 9: 159. Dostupné z DOI: <http://doi: 10.1186/1477–7819–9–159>.

4. Mandrekas AD, Zambacos GJ, Katsantoni PN. Immediate and delayed breast reconstruction with permanent tissue expanders. Br J Plast Surg 1995; 48(8): 572–578.

5. Alderman A, Gutowski K, Ahuja A et al. Postmastectomy ExpanderImplant Breast Reconstruction Guideline Work Group. ASPS Clinical Practice Guideline Summary on Breast Reconstruction with Expanders and Implants. Plast Reconstr Surg 2014; 134(4): 648e–655e. Dostupné z DOI: <http://doi: 10.1097/PRS.0000000000000541>.

6. Chun YS, Sinha I, Turko A et al. Outcomes and patient satisfaction following breast reconstruction with bilateral pedicled TRAM flaps in 105 consecutive patients. Plast Reconstr Surg 2009; 125(1): 1–9.

7.Nelson JA, Guo Y, Sonnad SS et al. A Comparison between DIEP and muscle-sparing free TRAM flaps in breast reconstruction: a single surgeon‘s recent experience. Plast Reconstr Surg 2010; 126(5): 1428–1435.

8. Mestak O, Sukop A, Hsueh YS et al. Centrifugation versus PureGraft for fatgrafting to the breast after breast-conserving therapy. World J Surg Oncol 2014; 12: 178. Dostupné z DOI: < http://doi: 10.1186/1477–7819–12–178>.

9. Mestak O, Zimovjanová M. Rekonstrukce prsů přenosem autologního tuku. [Breast reconstruction by autologous fat transfer]. Rozhl Chir 2012; 91(7): 373–377.

10. Mestak O, Mestak J, Bohac M et al. Breast Reconstruction after a Bilateral Mastectomy Using the BRAVA Expansion System and Fat Grafting. Plast Reconstr Surg Glob Open 2013; 1(8): e71. Dostupné z DOI: <http://doi: 10.1097/GOX.0000000000000022>.

11. Kelly DA, Wood BC, Knoll GM et al. Outcome analysis of 541 women undergoing breast conservation therapy. Ann Plast Surg 2012; 68(5): 435–437.