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Review
. 2017 Nov;140(5S Advances in Breast Reconstruction):7S-13S.
doi: 10.1097/PRS.0000000000003941.

Current Trends in Postmastectomy Breast Reconstruction

Hina Panchal  1   2 , Evan Matros  1   2
Affiliations
Review

Current Trends in Postmastectomy Breast Reconstruction

Hina Panchal et al. Plast Reconstr Surg. 2017 Nov.

Abstract

Postmastectomy immediate breast reconstruction in the U.S. continues to experience an upward trend owing to heightened awareness, innovations in reconstructive technique, growing evidence of improved patient-reported outcomes, and shifts in mastectomy patterns. Women with unilateral breast cancer are increasingly electing to undergo contralateral prophylactic mastectomy, instead of unilateral mastectomy or opting for breast conservation. The ascent in prophylactic surgeries correlates temporally to a shift toward prosthetic methods of reconstruction as the most common technique. Factors associated with the choice for implants include younger age, quicker recovery time, along with documented safety and enhanced aesthetic outcomes with newer generations of devices. Despite advances in autologous transfer, its growth is constrained by the greater technical expertise required to complete microsurgical transfer and potential barriers such as poor relative reimbursement. The increased use of radiation as an adjuvant treatment for management of breast cancer has created additional challenges for plastic surgeons who need to consider the optimal timing and method of breast reconstruction to perform in these patients.

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Figures

Figure 1
Figure 1
Temporal Trends of Surgical Treatment in Patients with Early Stage Breast Cancer from 1998–2011 Using National Cancer Database, IRR: Incidence Rate Ratio; NS: Not significant; Adapted from Albornoz et al. 2015 Source: Bilateral Mastectomy versus Breast-Conserving Surgery for Early-Stage Breast Cancer: The Role of Breast Reconstruction. Plastic and Reconstructive Surgery. 135(6): 1518–1526, June 2015.
Figure 2
Figure 2
Temporal Trends of Reconstructive Methods in Patients who underwent Mastectomy from 1998–2008, Using Nationwide Inpatient Sample Database IRR: Incidence Rate Ratio; NS: Not significant; Adapted from Albornoz et al. 2013 Source: A Paradigm Shift in U.S. Breast Reconstruction: Increasing Implant Rates. Plastic and Reconstructive Surgery. 131(1): 15–23, January 2013.
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