Abstract:

Objective

To explore the prognostic factors and desirable effect of immediate postmastectomy reconstruction for breast cancer patients.

Methods

One hundred and fifty women with breast cancer diagnosed pathologically，with mean age of 49±15 years and the tumor size 1.6±1.2 cm（no palpable lymph node），were operated on from Jan，1999 to Jul，2005 in Zhongshan Hospital.Mastectomy including traditional modified mastectomy in 11 cases，skin sparing modified mastectomy in 12 cases，nipple-areolar sparing modified mastectomy in 127 cases，was carried out.Breast reconstruction with latissimus dorsi myocutaneous flaps was performed in 139 cases and transverse rectus abdominis myocutaneous（TRAM）flaps breast reconstruction in 11 cases.

Results

Operation was successful in 149 cases；one case failed because of vessel damage，and other complications included herniation in the abdominal wall（1 case），palpable adipose mass in breast（6 cases），fat necrosis（3 cases），delayed wound healing of the abdominal trauma（3 cases），hematomas in the back（28 cases），limited skin necrosis（7 cases），implant loss（1 case with flap removed）and nipple necrosis（1 case）.The follow up rate was 82%（123 cases），with an average time of 36.6 months.The results revealed axillary lymph node metastasis in 2 cases，bone metastasis in 1 case，supra clavicular lymph node metastasis in 1 case and one women suicided.No local recurrence was found.We used the JCRT classification to evaluate the postoperative change of the shape，which showed best result 11.5%，good 49.3%，average 36.7%，poor 2.6% in best，good，average，poor results，separately.

Conclusion

Immediate postmastectomy reconstruction for breast cancer with adjuvant treatments is feasible and can obtain good therapeutic and cosmetic effect for patients with early breast cancer.

Key words: Breast neoplasms, Immediate breast reconstruction