Modalities ofDelayed Breast Reconstruction afterMastectomy
Ahmed Ramzy Shafik Elmaradny;
Abstract
Breast cancer is by far the most common cancer among women of both developed and developing countries accounting for22.9% of all female cancers. It is also the leading cause of cancer death in females accounting for 13.7% of their cancer related mortality.
Management of breast cancer can be divided generallyaccording to operability. Stages I, II and IIIA are consideredoperable cases. Stages IIIB and IIIC are borderline orpotentially inoperable cases while, stage IV is consideredinoperable.
Neoadjuvant treatment of breast cancer has become established as the safe and often effective therapeutic approach of choice for larger primary and for locally advanced breast cancer.
The essential goals of breast reconstruction remain creating a breast mound, maximizing symmetry between the reconstructed mound and the contralateral breast, and reconstructing a nipple in the appropriate position to transform the mound into a true breast image. Breast reconstruction has positive psychological effects as it reduces the psychological trauma attributed to loss of breast, regains woman's sense of femininity, elevates self-esteem and encourages sexual expressiveness.
Delayed reconstruction has its advantages for the patient who is unsure about reconstruction; it allows time to make the decision. The recovery period from the simple mastectomy is quicker. Patients do not typically have much choice about when they need cancer surgery, but they can delay the reconstruction until they have more time for recovery. In addition, it is usually easier and faster to schedule a simple mastectomy than for the breast surgeon and the plastic surgeon than to find time for a combined procedure. Patients can also proceed quicker to adjuvant therapy, if necessary, after a simple mastectomy.
Given the increased prevalence of BCT, attention has now focused on the cosmetic outcome that it provides. In general, most patients have a good to excellent result following BCT. One study found that physicians rated the overall cosmetic results obtained by BCT as excellent in 77% of cases, good in 9%, fair in 9%, and poor in 5%. A fair or poor cosmetic result was found to be correlated with the severity of breast retraction.
Contralateral breastusually needs further procedure to achieve symmetry such as mastopexy, augmentation, and reduction mammoplasty. Timing and type of reconstruction determine which method could be used.
Management of breast cancer can be divided generallyaccording to operability. Stages I, II and IIIA are consideredoperable cases. Stages IIIB and IIIC are borderline orpotentially inoperable cases while, stage IV is consideredinoperable.
Neoadjuvant treatment of breast cancer has become established as the safe and often effective therapeutic approach of choice for larger primary and for locally advanced breast cancer.
The essential goals of breast reconstruction remain creating a breast mound, maximizing symmetry between the reconstructed mound and the contralateral breast, and reconstructing a nipple in the appropriate position to transform the mound into a true breast image. Breast reconstruction has positive psychological effects as it reduces the psychological trauma attributed to loss of breast, regains woman's sense of femininity, elevates self-esteem and encourages sexual expressiveness.
Delayed reconstruction has its advantages for the patient who is unsure about reconstruction; it allows time to make the decision. The recovery period from the simple mastectomy is quicker. Patients do not typically have much choice about when they need cancer surgery, but they can delay the reconstruction until they have more time for recovery. In addition, it is usually easier and faster to schedule a simple mastectomy than for the breast surgeon and the plastic surgeon than to find time for a combined procedure. Patients can also proceed quicker to adjuvant therapy, if necessary, after a simple mastectomy.
Given the increased prevalence of BCT, attention has now focused on the cosmetic outcome that it provides. In general, most patients have a good to excellent result following BCT. One study found that physicians rated the overall cosmetic results obtained by BCT as excellent in 77% of cases, good in 9%, fair in 9%, and poor in 5%. A fair or poor cosmetic result was found to be correlated with the severity of breast retraction.
Contralateral breastusually needs further procedure to achieve symmetry such as mastopexy, augmentation, and reduction mammoplasty. Timing and type of reconstruction determine which method could be used.
Other data
| Title | Modalities ofDelayed Breast Reconstruction afterMastectomy | Other Titles | الانماط المختلفه لاعاده بناء الثدي المتاخره بعد استئصاله | Authors | Ahmed Ramzy Shafik Elmaradny | Issue Date | 2015 |
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