Introduction to breast reconstruction after breast cancer surgery

  Breast reconstruction refers to the use of autologous tissue transplantation or breast implants to reconstruct breast wall deformities and breast loss caused by mastectomy, and can also be seen in burns, trauma, infection, congenital dysplasia, sex reassignment surgery, etc. Unilateral breast reconstruction is most common. At present, breast reconstruction after breast cancer surgery is just starting in China, but it has already played an important role in developed countries, so the understanding of breast reconstruction needs to be strengthened and promoted in China.  Breast reconstruction can be divided into two types according to the timing of surgery: one is to perform breast reconstruction at the same time of mastectomy, called immediate breast reconstruction, which is mainly applicable to early stage breast cancer (stage I breast cancer and some stage II breast cancer) with a high possibility of complete cure; the other is to perform breast reconstruction 3-6 months after mastectomy, called postponed breast reconstruction (stage II reconstruction). There are several surgical approaches to breast reconstruction, but there is no single surgical approach that can be used for all patients who need breast reconstruction. Currently, there are two major types of breast reconstruction: breast reconstruction with implants and breast reconstruction with self-tissue grafting. The choice of reconstruction method is based on the patient’s specific conditions and the amount of local breast tissue. If the patient has sufficient local breast tissue, the prosthesis can be placed directly under the skin or pectoralis major muscle; if the tissue is moderately deficient, the prosthesis can be placed after subcutaneous or submuscular tissue expansion; if the tissue is severely deficient, the autologous muscle flap can be used as the reconstruction material, such as rectus abdominis muscle flap, latissimus dorsi muscle flap, etc. Most breast cancer patients belong to this type after surgical removal of the tumor. Most of the breast cancer patients belong to this type after surgical removal of tumor.  It is predicted that the development trend of breast reconstruction in China is that the number of patients requiring breast reconstruction after breast cancer surgery, especially immediate breast reconstruction, will gradually increase; the tipped rectus abdominis muscle flap and latissimus dorsi muscle flap are still the basic procedures for breast reconstruction; immediate stage I breast reconstruction using latissimus dorsi muscle flap will probably become mainstream in the future. It is believed that as the understanding of breast cancer and breast reconstruction deepens and the surgical techniques continue to improve, breast reconstruction will be developed significantly.