BREAST RECONSTRUCTION FOLLOWING BREAST CANCER
Operative therapy of breast cancer
The choice of the surgical method for breast cancer must be orientated in the first instance towards eliminating the tumour with the greatest degree of certainty. Aesthetic considerations must always play a secondary role here, following after the oncological necessities. Although today’s breast-conserving therapy procedures mean that most patients are spared breast amputation, depending on the type of tumour, localisation and extent, the affected breast has to be completely removed for a large number of women. It is an indisputable fact that for any woman breast amputation is a momentously grave intrusion into their physical integrity. The woman experiences an emotional trauma to varying individual degrees, which is often only overcome after years, if ever. An understanding of the various reconstruction options may help many women deal with the shock of breast removal.
The modern techniques of plastic surgery have significantly broadened the spectrum of surgical options for breast reconstruction over the last few years. With the introduction of microsurgery in reconstructive breast surgery, it has been possible to achieve far better aesthetic results in breast shape as well as significantly reduce donor site morbidity in autologous tissue reconstruction. The question of which of the surgical procedures described can be applied to an individual patient is influenced by many factors and an individual indication is vital for each patient.
The application of a particular procedure depends, for example, on the local ratio of skin to soft tissue, the consequences of previous operations or the likelihood of follow-up radiotherapy. Whether immediate reconstruction is possible is determined not only by oncological criteria but also by the over all constitution of the patient. Any breast reconstruction must be preceded by a comprehensive explanatory consultation between the surgeon and the patient in order to ensure that no exaggerated expectations are held and to be able to clarify the limitations and possible complications of the particular reconstruction method.
Although breast reconstruction is now an integral part of the therapy concept of breast cancer, no oncological compromises can be allowed in favour of aesthetics.