We are encountering an increasing number of immediate reconstruction patients who have undergone a previous non-skin-sparing mastectomy and delayed autologous reconstruction and are subsequently faced with a metachronous cancer of the remaining native breast. If the patient is to undergo a skin-sparing mastectomy and is satisfied with her previous reconstruction, is it aesthetically preferable to preserve the native skin envelope and decrease scar burden, or is it better to include more skin with the planned autologous tissue transfer thereby maintaining symmetry with the previous reconstruction? Although much has been written on immediate reconstruction of the contralateral breast in cases of synchronous bilateral breast cancer or premalignant breast disease, no literature exists to guide decision-making in these metachronous cases.
- Isern A.E.
- Tengrup I.
- Loman N.
- et al.
Aesthetic outcome, patient satisfaction, and health-related quality of life in women at high risk undergoing prophylactic mastectomy and immediate breast reconstruction.
J Plast Reconstr Aesthet Surg. 2008; 61: 1177-1187
2As 1% of patients may develop a contralateral, sequential breast cancer, this question is likely to persist.
- Craft R.O.
- Colakoglu S.
- Curtis M.S.
- et al.
Patient satisfaction in unilateral and bilateral breast reconstruction.
Plast Reconstr Surg. 2011; 127: 1417-1424
- Nichols H.B.
- Berrington de Gonzalez A.
- Lacey Jr., J.V.
- et al.
Declining incidence of contralateral breast cancer in the United States from 1975 to 2006.
J Clin Oncol. 2011; 29: 1564-1569
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- Aesthetic outcome, patient satisfaction, and health-related quality of life in women at high risk undergoing prophylactic mastectomy and immediate breast reconstruction.J Plast Reconstr Aesthet Surg. 2008; 61: 1177-1187
- Patient satisfaction in unilateral and bilateral breast reconstruction.Plast Reconstr Surg. 2011; 127: 1417-1424
- Declining incidence of contralateral breast cancer in the United States from 1975 to 2006.J Clin Oncol. 2011; 29: 1564-1569
- Nipple and areola reconstruction: a study of 79 mastectomised women.Scand J Plast Reconstr. 1983; 17: 233-240
- Long-term predictable nipple projection following reconstruction.Plast Reconstr Surg. 1999; 104: 1321-1324
Published online: May 04, 2012
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.