Breast reconstruction after mastectomy.

In Denmark mastectomized women have shown an increasing interest in breast reconstruction. Secondary reconstruction one year after completed oncologic treatment is recommended. Patients are selected in collaboration with the oncologic treatment centers mainly from the group with localized (stage I) disease. Reconstruction of the breast dome is most commonly accomplished by submuscular implantation of a soft silicone prosthesis, often preceded by tissue expansion or combined with transfer of a musculocutaneous flap. In some cases flap transfer may provide sufficient bulk to eliminate the need for a prosthesis. Reconstruction of the nipple-areola complex is performed some months later, when symmetry in breast volume and placement has been established. Altogether the reconstructions may take 1/2-1 year in uncomplicated cases depending on the method used. The cosmetic results achieved are sufficiently good to warrant a recommendation that reconstructive surgery should be available--according to need--as an integral part of the treatment of women with breast cancer.