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Breast Cancer Management for Surgeons pp 315–323Cite as

Immediate Reconstruction: General and Oncological Considerations

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Abstract

Breast cancer treatments have undergone major improvements in the last 20 years. Breast conservation is now possible and desirable for the majority of women, and axillary dissection has been progressively replaced by sentinel node biopsy. However, some patients will still be advised to, or choose to, have a mastectomy. European guidelines recommend that every woman facing a mastectomy should be offered breast reconstruction, if appropriate, either immediate or delayed, taking into account patient and tumour factors and individual preferences.

Immediate breast reconstruction (IBR) has become a widely available option, and apart from inflammatory breast cancer, there are no other absolute contraindications to the procedure if desired by the patient. Postmastectomy radiotherapy (PMRT) does have an impact on outcome but is considered only as a relative contraindication to IBR. The choice of the technique for IBR is complex and should consider the optimal cosmetic outcome balanced against surgical morbidity and without compromising adjuvant treatments.

Measures of quality of life and cosmetic outcome are scarce and lack uniformity. However, they need to be recorded so that results can be evaluated and compared in an objective manner. The use of decision trees, with the inclusion of the more important factors involved in the process, can aid a more informed choice and reduce morbidity.

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Author information

Authors and Affiliations

  1. Breast Unit, Champalimaud Clinical Center, Champalimaud Foundation, Av Brasilia s/n, 1400-038, Lisbon, Portugal

    Maria João Cardoso MD, PhD

  2. Breast Unit, Azienda Ospedaliera Cannizzaro, Catania, Italy

    Giuseppe Catanuto MD, PhD

Authors
  1. Maria João Cardoso MD, PhD
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  2. Giuseppe Catanuto MD, PhD
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Corresponding author

Correspondence to Maria João Cardoso MD, PhD .

Editor information

Editors and Affiliations

  1. The Medical School Department of Oncology, University of Sheffield, Sheffield, United Kingdom

    Lynda Wyld

  2. Athens University Medical School, Athens, Greece

    Christos Markopoulos

  3. Helsinki University Hospital, Helsinki, Finland

    Marjut Leidenius

  4. Department of Oncology & Radiotherapy, Gdańsk Medical University Department of Oncology & Radiotherapy, Gdańsk, Poland

    Elżbieta Senkus-Konefka

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Cardoso, M.J., Catanuto, G. (2018). Immediate Reconstruction: General and Oncological Considerations. In: Wyld, L., Markopoulos, C., Leidenius, M., Senkus-Konefka, E. (eds) Breast Cancer Management for Surgeons. Springer, Cham. https://doi.org/10.1007/978-3-319-56673-3_27

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  • DOI: https://doi.org/10.1007/978-3-319-56673-3_27

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-319-56673-3

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