Breast Cancer and Breast Reconstruction

  1. Breast cancer can bring panic to patients, and the loss of breast can bring physical and psychological troubles to patients. Breast reconstruction is a blessing for breast cancer patients with breast loss, enabling them to reshape their bodies and embrace a new life. Breast reconstruction follows the basic aesthetic principles of breasts and takes the contralateral breast as the standard. Through repairing skin defects of chest wall, teardrop breast reconstruction, repairing anterior axillary fold defects, filling subclavian void, nipple areola reconstruction and repairing asymmetry of both breasts, we can reconstruct breasts with aesthetic outline, certain protrusion and drape, and symmetry with the contralateral breast, so as to restore the beauty of women’s breasts to the greatest extent.  2. Breast reconstruction principles and indications: Breast reconstruction should follow the following two principles: ① not to interfere with the treatment of breast cancer, not to affect the efficacy and prognosis, not to affect the detection and retreatment of tumor recurrence; ② the reconstructed breast is in good shape, which can improve the body image of breast cancer patients, reduce psychological trauma and improve the quality of life of patients. Breast reconstruction indications. The development of breast-conserving surgery has enabled some breast cancer patients to avoid mastectomy.  It is reported that the mastectomy rate of breast cancer patients in China is still as high as 80%. Patients with the following conditions still need to have their breasts removed: ① cancer in or near the nipple areola area; ② multicenter or multifocal cancer; ③ locally advanced breast cancer with large tumor size, which is not suitable for breast conservation; ④ patients cannot receive postoperative radiotherapy or are unwilling to receive radiotherapy; ⑤ patients wish to have their breasts removed; ⑥ after breast-conserving surgery, it is found that the cut edge is not clean or local recurrence. Patients with stage I and II breast cancer with a higher chance of cure, or mastectomized patients without local recurrence and distant metastases after adjuvant treatment such as radiotherapy and chemotherapy are suitable candidates for breast reconstruction, while those with distant metastases are contraindicated for breast reconstruction.  3.What are the methods of breast reconstruction? According to the time of breast reconstruction, there are immediate breast reconstruction (stage I breast reconstruction) and delayed breast reconstruction (stage II breast reconstruction). Immediate breast reconstruction refers to breast reconstruction at the same time as mastectomy. It has the following advantages: (1) the mastectomy and reconstruction are completed in one time, reducing hospitalization time and cost; (2) the patient does not experience the psychological barrier of losing the breast; (3) the shape of the reconstructed breast is better. It does not affect the subsequent treatment of breast cancer, such as chemotherapy, radiotherapy, endocrine therapy, etc., and does not increase the risk of local recurrence. Delayed breast reconstruction can be performed six months to one year after mastectomy, i.e. after chemotherapy and radiotherapy are finished, and the disease is monitored for stability.  4.Breast reconstruction is divided into autologous tissue breast reconstruction, artificial prosthesis breast reconstruction and combined breast reconstruction of both according to the material used for breast reconstruction. Breast reconstruction with autologous tissue transplantation has long-lasting effect and realistic appearance. It has the following advantages: (1) it can make full use of the patient’s autologous tissues; (2) it can avoid a series of complications that may be brought about by prosthesis; (3) it has good texture, easy to shape, good sense of sagging, and can correct subclavian depression and deformity of the anterior axillary wall; (4) it can not only tolerate postoperative radiation therapy, but also be applied to patients who have received radiation therapy and underwent extensive excision due to recurrence; (5) (5) Autologous tissues with good blood flow can promote the healing of bad wounds and ulcers.