Study for the Efficacy and the Safety of Immediate Breast Reconstruction Following a Curative Mastectomy

ABSTRACT

Immediate reconstruction of a breast after a curative mastectomy is a good alternative to a breast conserving operation and can be accomplished without altering the cancer-ablative purpose. The transversus rectus abdominis myocutaneous(TRAM) flap has proven to be the most useful autogenous tissue for restoring a breast. We evaluated 14 cases of breast cancer in which the patient underwent immediate TRAM flap reconstruction by the same surgeons who had performed the curative mastectomy. Immediate TRAM reconstruction was performed safely in all stages of breast cancer, although the majority of the patients were in stage 2. Partial necrosis of the myocutaneous flap(1 case), partial necrosis of the breast skin(1 case), hematoma(2 cases), and wound infection(1 case) developed as postoperative complications and were controlled by conservative management. Postoperative chemotherapy and chemoradiation therapy were performed in 7 cases and 4 cases, respectively, without any discernible adverse influence on the myocutaneous flap. The majority of the patients were satisfied with the reconstructed breast. Based on these results, we suggest that immediate breast reconstruction using the pedicled TRAM flap can be accomplished by the surgeon who performed the mastectomy and will enhance cosmetic appearance without any adverse impact on curabilitly.