BREAST RECONSTRUCTION AFTER MASTECTOMY IN HONG-KONG CHINESE

Breast reconstruction in Western countries is considered an essential part of the total management of breast cancer. This concept may differ somewhat in oriental patients because of certain psyche-social consid erations and notably different breast morphology. Over a six-month per iod, 52 patients were diagnosed with breast cancer among 331 patients presenting to the breast surgical clinic at the Prince of Wales Hospit al. Total mastectomy with axillary clearance was indicated for these p atients. After excluding two patients who required mandatory reconstru ction after salvage mastectomy, 35 patients under the age of 60 were c onsidered suitable candidates for breast reconstruction. 19 patients ( 54%) opted for breast reconstruction, their ages ranged from 20 to 53 years with a mean age of 37. 14 patients had reconstruction using a sa line mammary implant, three patients using a transverse rectus abdomin us myocutaneous (TRAM) flap and two patients with a Latissimus Dorsi M yocutaneous flap. Only two patients had nipple and areola reconstructi on; the others showed no interest in having further surgery. Complicat ions included a partial TRAM flap necrosis, which was managed under lo cal anaesthesia and one patient who had the saline implant removed bec ause of obsessive anxiety over a foreign body. The remaining patients expressed extreme satisfaction after breast reconstruction. Since then , all patients have been fully informed about breast reconstruction an d the related complications whenever mastectomy is indicated so that a well informed decision can be made. This article analyses the patient s' perception, outcome and our experience after two years follow up re garding breast reconstruction among Chinese patients.