| Abstract: |
When a breast cancer patient is confronted with the potential need for adjuvant radiotherapy following mastectomy, deciding on the type and timing of breast reconstruction can be overwhelming. To help guide the complex decision-making process, we have proposed a practical and comprehensive reconstructive algorithm. Our first major decision branching point depends on the type of reconstruction that the patient desires (prosthetic vs. autologous tissue), and the second major branching point depends on the desired timing of reconstruction. For a patient who both desires and meets the requirements for expander/implant reconstruction, immediate reconstruction using the Memorial Sloan-Kettering Cancer Center protocol is our preferred method of reconstruction in the setting of expected postmastectomy radiotherapy (PMRT). On the other hand, if the patient’s first choice is autologous tissue reconstruction, then it is preferable to delay breast reconstruction following PMRT. Delayed immediate breast reconstruction is an appropriate alternative for patients with early or intermediate stage disease whose top priority is to preserve the skin envelope to maximize aesthetic outcome. This treatment algorithm is tremendously useful as a guide to help patients select the most suitable method and timing of breast reconstruction in the setting of PMRT. © Springer-Verlag Italia 2013. |
