專題討論6:乳癌治療之新進展

S6-3
Cosmetic aspect and Local Relapse after Immediate Reconstruction
Jung-Ju Huang, MD
Division of reconstructive microsurgery
Department of plastic and reconstructive surgery
Chang Gung Memorial Hospital
Chang Gung University

  Immediate breast reconstruction is considered to have superior aesthetic reconstruction result due to the preservation of the skin envelop during mastectomy. However, the decision making of performing immediate breast reconstruction can be very difficult. Postoperative radiotherapy is indicated in patients with more advanced breast cancer. However, radiotherapy can damage the reconstructive breasts as well. It is recommended now that immediate breast reconstruction should be performed in patients with stage I breast cancer, who will not received radiotherapy thereafter. However, even with highly selection, there are some patients requiring radiotherapy after breast cancer surgery and reconstruction when the postoperative pathological results change their tumor staging.

Immediate breast reconstruction is considered to be superior in aesthetic aspect due to well preservation of the skin envelope, which can be a guide of flap inset or implant position. The preservation of the breast pocket also helps in achieving symmetry in bilateral breast reconstruction. It is reported in literatures that the requirement of refinement procedures in both the reconstructed breast and the contralateral breast are less in patients with immediate breast reconstruction. In this presentation, we will review our experiences on the aesthetic aspect of the reconstructed and contralateral breasts.

In the other hand, local recurrence on the reconstructed breast is complicated due to the treatment of choice and the possible effect on the reconstructed breast. We reviewed our immediate breast reconstruction patients with local recurrence to document the time, location and relationship between the previous cancer and the local recurrence cancer. The treatment and patients’ prognosis are also reviewed.