Primary and secondary breast reconstruction with special emphasis on the use of prostheses.

Abstract

Breast reconstruction (BR) is widely accepted as part of the surgical treatment of breast cancer, although mastectomy is less frequently indicated. Delayed breast reconstruction (DBR) is available for patients having undergone a mastectomy in the past, and immediate breast reconstruction (IBR) can be proposed at the time of mastectomy, especially in case of diffuse or extensive in situ carcinomas. Patients with infiltrating carcinomas who require mastectomy are increasingly treated with adjuvant chemotherapy. Therefore, IBR should be considered as an option only if it does not postpone medical treatment, since delay of adjuvant treatment due to IBR can increase the risk of complications, these being directly related to the IBR technique. An evaluation of the risk should help us to decide whether IBR is safe or not when adjuvant treatment is required.