1.What should I do if I have breast cancer? Breast cancer is currently the first malignant tumor among women. If breast cancer is detected, you need to go to breast surgery for radical breast cancer surgery and communicate with breast surgeons and plastic surgeons for consultation on whether to perform stage I breast reconstruction. 2.Why should breast cancer patients undergo breast reconstruction? Breast is the symbolic organ of female secondary sex characteristics, female breast cancer patients not only face the threat of lethal disease, but also have to suffer the psychological blow of physical disability. With the improvement of medical technology, more emphasis is placed on preserving and improving the quality of life of patients while curing the tumor. Radical mastectomy plus breast reconstruction achieves the dual effect of radical mastectomy and reconstruction, alleviates the psychological barriers brought to patients by mastectomy, corrects the physical defects, improves patients’ quality of life, and plays a great psychotherapeutic role. 3.Does immediate breast reconstruction affect the prognosis of breast cancer? A large number of studies have proven that the safety of immediate breast reconstruction in oncology treatment is reliable, and its complication rate, tumor recurrence rate, detection rate after recurrence and death rate are not different from those of radical breast cancer surgery alone. Most patients with breast cancer undergo chemotherapy and radiation therapy after surgery, so for patients with immediate reconstruction, the impact of radiation and chemotherapy on the reconstructed breast needs to be considered. The optimal time between surgery and the start of radiation and chemotherapy is 14 to 21 days, which is sufficient time for patients to recover from additional immediate breast reconstruction. The Washington Cancer Treatment Center compared immediate breast reconstruction with no difference in the time to start chemotherapy between patients who had immediate breast reconstruction and those who did not, with no delay in adjuvant chemotherapy and little impact on the reconstructed breast. Patients with stage I, II, III, and prophylactic mastectomy are candidates for immediate reconstruction. Patients with direct primary tumor invasion of the chest wall (T4) and advanced tumors (stage IV) are not candidates for immediate breast reconstruction. The specific situation should be decided by the joint discussion between the mammographer and the plastic surgeon. 4.How many types of breast reconstruction are there? Breast reconstruction is divided into immediate breast reconstruction and delayed breast reconstruction. Immediate breast reconstruction refers to the simultaneous operation of radical surgery and breast reconstruction surgery; delayed breast reconstruction refers to the reconstructive surgery after radical surgery, usually 6-12 months after the incision is healed. 5.What are the timing options for breast reconstruction? The advantages of timely breast reconstruction are: excision and reconstruction are completed in one time, reducing hospitalization time and cost, no significant impact on patient’s prognosis, and even if local recurrence and distant metastasis occur, radiotherapy and biological endocrine therapy can be performed as usual after radical breast cancer surgery. The disadvantages of immediate breast reconstruction are mainly in the psychological impact on patients. On the one hand, patients are mostly reluctant to undergo reconstructive surgery psychologically because of the huge blow of cancer; on the other hand, patients often have too high expectations of reconstructive surgery because they have not suffered the pain of breast loss. The advantages of delayed breast reconstruction are: after a period of time, the patient’s fear of cancer recurrence is significantly reduced, and it is easier for the patient to accept breast reconstruction psychologically; in addition, after experiencing the pain of breast loss for a long time, the patient is easily satisfied with the reconstructed breast. The disadvantage is that the patient has to undergo two surgeries, and the results of the reconstruction are not as good as those of immediate breast reconstruction. In general, immediate breast reconstruction is more superior than postponed breast reconstruction. 6. What are the principles and indications for breast reconstruction after breast cancer surgery? Breast reconstruction for breast cancer patients should be considered from the perspective of tumor treatment safety and cosmetic surgery, and should follow the following two principles: (1) The technology used for reconstruction will not interfere with the treatment of breast cancer, and will not affect the efficacy and prognosis of the treatment, or the immediate detection and retreatment of tumor recurrence. (2) The reconstructed breast should achieve ideal cosmetic and functional effects, improve the postoperative body image of breast cancer patients, prevent or reduce psychological trauma, and improve the quality of life of patients. 7.What are the methods of unilateral breast reconstruction? There are three main methods: (1) artificial breast implant placement: (2) autologous tissue transplantation: taking own tissue from the abdomen, back and buttocks to reconstruct the breast; (3) a combination of both. 8.What are the advantages and disadvantages of breast reconstruction with implants? Breast reconstruction with implants has the advantages of a relatively simple surgical procedure and good aesthetic results, and there is no need for donor tissue and less surgical scarring. The disadvantages are that the shape of the implant will not change with the change of body position after surgery, and the shape of the implant will be easily detected because of the removal of more glands and fat during radical excision of breast cancer. 9.What are the advantages and disadvantages of breast reconstruction by autologous tissue grafting? The most significant advantage of breast reconstruction with tissue grafting is that the appearance and feel of the reconstructed breast is very similar to that of the natural breast, and the donor tissue can be shaped and trimmed in one stage to resemble the size and shape of the opposite breast. Autologous tissue transplantation is suitable for patients with large mastectomy areas and large autologous skin defects. For lower abdominal transverse rectus abdominis muscle flap with tip or free transplantation can also play the effect of abdominoplasty, which can perform abdominoplasty at the same time as breast reconstruction, and for middle-aged and obese women who have a high prevalence of breast cancer, it can be a double benefit. The disadvantage of autologous tissue breast reconstruction is that the surgical procedure is relatively complex, with a relatively long abdominal scar and postoperative recovery period. If the distal blood supply of the flap is insufficient or the apparent microvascular anastomosis fails, complications including partial or even total flap necrosis may also occur. 10.Can autologous breast reconstruction be solved in one operation? The first surgery will make the general shape of the breast, and after half a year, local adjustment of breast shape will be done to make both sides more symmetrical, and nipple reconstruction can be done at the same time. 11.What is the approximate cost of breast reconstruction? The cost of immediate breast reconstruction with autologous tissue is about 10,000 RMB, and the cost of delayed breast reconstruction with autologous tissue is 25,000-30,000 RMB; the cost of immediate breast reconstruction with prosthesis is about 20,000 RMB, and the cost of delayed breast reconstruction with prosthesis is about 35,000 RMB. 12.How long do I need to stay in hospital for breast reconstruction? Extended breast reconstruction requires about 10 days of hospitalization for the first surgery and about a week for the second partial revision of the nipple. The hospitalization time for immediate reconstruction is the same as that for radical breast cancer treatment.