[Breast reconstruction following amputation for cancer].
OBJECTIVE
Today, breast reconstruction is a widely accepted method in the treatment of breast cancer after modified radical mastectomy. Reconstruction methods are associated with an acceptable number of complications and reconstruction favourably impacts quality of life. The aim of the study was to present our experience in breast reconstruction.


METHODS
We presented here a four-year experience with 84 patients with breast reconstruction after modified radical mastectomy.


RESULTS
Implant reconstructions were most common, 44 (52.3%), with primary reconstruction in 31 (70.4%) and secondary in 13 (29.5%) women. Lattisimus dorsi flap (LDF) and implant were utilized in 32 (38%) of the patients, with primary reconstruction in 24 (75%) and secondary in 8 (25%) women. Transversal rectus abdominis myocutaneous (TRAM) flap was rarely used -- just in 8 (9.5%) patients and only for secondary breast reconstruction. Postoperatively, some early complications such as hematoma, seroma, infections and partial flap necrosis were observed in 10 (11.9%) patients. Late complications, such as implant rejection, hypertrophic scarring and hernias at the flap elevation site, were noted in 10 (11.9%) cases. Implant loss occurred in 5 (5.9%) cases. All the complications were successfully managed, and patients rated their reconstruction as follows: excellent, 49 (59%) cases; very good, 20 (24%), and good, 14 (16.8%). In one case, disease progression was observed 6 months after the primary breast reconstruction.


CONCLUSIONS
Breast reconstruction is an acceptable method in the treatment of breast cancer in patients in the need for or with already performed mastectomy. The choice of reconstruction approach depends on the breast volume, patient's wish and experience of surgical team. Our results suggest the advantage of breast reconstruction with LDF with implant, since the technique is safe, complications relatively rare and easily manageable, and the results are excellent or very good in each woman.
Visnjić
Milan
M
Klinicki centar Nis, Hirurska klinika, Nis, Srbija. visnic@medfak.ni.ac.rs
Kovacević
Predrag
P
Paunković
Ljiljana
L
Dordević
Goran
G
Budevac
Dragana
D
Visnjić
Aleksandar
A
D000328:Adult; D018427:Breast Implants; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D015411:Mastectomy, Modified Radical / Q000534:rehabilitation*; D008875:Middle Aged; D013524:Surgical Flaps; D055815:Young Adult