J.Jpn. Surg. Soc.. 88(9): 1176-1179, 1987

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Report on the annual meeting

RECONSTRUCTIVE SURGERY IN BREAST CARCINOMAーRECONSTRUCTION AFTER MASTECTOMY AND CHEST WALL RECONSTRUCTION

With the increased knowledge of breast cancer and its implications, many women are unwilling to accept the deformity that results from the surgical treatment of this disease. The acceptance of modified mastectomy as the procedure of choice in carcinoma of the breast has resulted in selected patients being offered rehabilitation by restoration of the breast contour at the time of definitive surgery. Since 1982, 81 patients have had breast reconstruction after modified mastectomy for breast malignancy at NCCH. As a result, 79 breast malignancies involved the breasts had immediate approach. We have selected for this procedure those breast cancer patients with a high probability of being cured and a low probability of developing a local recurrence. The lesion must be palpably 2cm more or less in size and outer half of the breast. No clinically positive nodes should be felt in the axilla (NO and/or N1a). In our series, latissimus dorsi musculocutaneous fiaps were used in all but two reconstruction, where a transverse lower rectus abdominis musculocutaneous flaps were substituted. Lymph nodes remained uninvolved by tumor in most of the cancer patients (66) excluding 10.
The author recommends an immediate reconstruction of the breast as a safe treatment option with aminimum of mental and emotional anxiety. It also provides adjunctive therapy in the local recurrence and aids in treatment of radionecrotic chest wall.

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