Modified radical mastectomy with immediate breast reconstruction.

The authors reviewed 100 consecutive patients with breast cancer treated by modified radical mastectomy and immediate breast reconstruction in order to assess the safety and efficacy of this procedure in terms of cancer control. The study began in 1978 and is continuing. The procedure involves a two-team approach with both the general surgeon and the plastic surgeon interviewing the patient preoperatively. Virtually all breast reconstruction involved the use of a submuscular silicone saline type of implant. The median follow-up is 36 months. Slightly over half of these cases were Stage 0 or Stage I. There have been eight recurrences, including five local or regional and three distant. No patient has died of her disease at this point. Cosmesis was equal to or superior to that seen in delayed breast reconstruction. There have been no hidden recurrences. Postoperative depression has been significantly less. We conclude that modified radical mastectomy with immediate breast reconstruction is a safe and effective alternative to modified radical mastectomy alone.