BREAST RECONSTRUCTION AFTER MASTECTOMY

The management of the woman with breast cancer who requires mastectomy should involve a multidisciplinary approach which includes dose colla boration between the oncological surgeon, the medical oncologist, the radiation oncologist and the reconstructive surgeon. The reconstructiv e surgeon can be a useful source of information for the patient with r espect to the available options for breast reconstruction as well as a ppropriate techniques and timing, Current evidence supports the use of immediate breast reconstruction which can be performed either by spec ialist breast surgeons who are trained in both oncological and reconst ructive surgery, or by a plastic surgeon. Advances have made reconstru ction possible for almost all patients. The goals of breast reconstruc tion include creation of a long lasting, natural breast which meets th e psychological and aesthetic needs of the patient without major morbi dity at the donor site or compromise of sound oncolgic management. Aut ologous tissue reconstruction using the TRAM flap has become the prefe rred method in the USA due to the excellent results which are achieved without the need for silicone implants. Although these procedures are not without complications, careful patient selection and modification s of the technique have added to breast reconstruction safety and reli ability. Current evidence supports the use of immediate breast reconst ruction which can be performed either by specialist breast surgeons wh o are trained in both oncological and reconstructive surgery or by a p lastic surgeon.