[Immediate breast reconstruction: indications and technics. Apropos of 120 cases treated at the Institut Gustave-Roussy].

From 1976 to 1986 one hundred and twenty immediate breast reconstructions (IBR) were performed at the Gustave-Roussy Institut. 90% of these cases were treated for in situ or infiltrating carcinomas, while only 10% had prophylactic mastectomy. Over recent decades indications for IBR have progressively changed. In the first period they were reserved for prophylactic mastectomies and in situ carcinomas. Over the last several years IBR has also been proposed to patients with infiltrating carcinomas (30%). Although the adequate treatment for small invasive carcinomas is a radiosurgical conservative procedure, a mastectomy is still indicated in stage II, over three centimeters multifocal carcinomas, and local recurrence after conservative treatment. In our series, this procedure seems safe and advisable as it does not interfere with the treatment of primary and secondary disease. The low incidence of surgical complications reported in our series did not increase the hospital stay of our patients. Indications, surgical techniques including myocutaneous flaps, and results of IBR will be discussed.