Update on breast reconstruction in breast cancer.

Overview

PURPOSE OF REVIEW: Presented is a brief overview of the current state of postmastectomy reconstruction. RECENT FINDINGS: Breast reconstruction has been shown to have a positive effect on the psychological well being of women with breast cancer. Numerous studies have demonstrated that reconstruction performed concurrently with mastectomy is oncologically safe. Nevertheless, although increasing numbers of women are choosing to undergo postmastectomy reconstruction, this trend is inconsistent across demographic subgroups. In addition, the paradigm of performing immediate reconstruction on all-comers is being challenged by increasing use of postoperative radiotherapy. It is now appreciated that the implications of performing reconstruction in the setting of radiotherapy are both profound and controversial. Finally, questions are being raised about the factors that influence the ultimate surgical goal, namely patient satisfaction. It is anticipated that future investigations using newly developed, patient-reported outcome measures will provide important information about outcomes following reconstruction, which in turn will facilitate the decision-making process for both patients and surgeons. SUMMARY: Recent refinements in surgical techniques and prosthetic technologies, development of novel tissue substitutes, and increasing use of adjuvant radiotherapy have led to changes in the practice of breast reconstruction following mastectomy.