Breast reconstruction. State of the art.

Some variant of mastectomy remains the mainstay of the treatment of the primary tumor for the vast majority of the 110,000 new cases of cancer of the breast which will be treated this year in the United States. Reconstruction of the breast after ablation for cancer has become an integral part of the therapeutic regimen of this disease. With the increase in availability and dissemination of information about reconstruction, women expect the opportunity to discuss the options of such surgical rehabilitation after mastectomy. The three major questions arise in regard to reconstruction of the breast: (1) Who should be reconstructed? (2) When should the reconstruction be performed? (3) How should the goals of reconstruction be realized? In answer to these questions, healthy reconstruction is available for any patient, provided she is well enough to undergo the surgical procedure. This may be performed immediately at the time of the ablative mastectomy or delayed for a period of 3 months or more. The nature of the reconstructive procedure is tailored according to the nature of the mastectomy and residual deformity. The authors present their philosophy as to who should be reconstructed, when the optimum time is for this procedure, and their techniques for fulfilling these goals.