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.
1
,
2
As 1% of patients may develop a contralateral, sequential breast cancer, this question
is likely to persist.
3
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References
- 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
Article info
Publication history
Published online: May 04, 2012
Identification
Copyright
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
