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Review
. 2018 Jun;64(6):424-432.

Breast reconstruction: Updated overview for primary care physicians

Ron B Somogyi  1 , Natalia Ziolkowski  2 , Fahima Osman  3 , Alexandra Ginty  4 , Mitchell Brown  5
Affiliations
Review

Breast reconstruction: Updated overview for primary care physicians

Ron B Somogyi et al. Can Fam Physician. 2018 Jun.

Abstract

Objective: To offer primary care providers a comprehensive summary of breast reconstruction options and complications.

Quality of evidence: A literature search was conducted in PubMed with no time restriction using the search terms breast reconstruction, summary, review, complications, and options. Levels of evidence range from I to III.

Main message: As breast cancer survival rates increase, the focus of breast cancer management must shift to include the restoration of a patient's quality of life after cancer. Breast reconstruction plays a crucial role in the restoration of normality for these women. Women who undergo mastectomy often suffer from challenges related to body image, self-esteem, and a decrease in quality of life scores. Cancer Care Ontario's Breast Cancer Treatment Pathway Map mandates that all women diagnosed with breast cancer who might require mastectomy be referred to a plastic surgeon to discuss reconstructive options before surgery.

Conclusion: The knowledge and guidance of primary care providers is critical to effectively guiding and supporting patients who might undergo breast reconstruction in their decision-making processes. A thorough understanding of patient selection factors, modern options for breast reconstruction, and expected outcomes is essential.

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Figures

Figure 1.
Figure 1.
Types of mastectomy incisions: A) Horizontal (skin-sparing mastectomy), B) skin-reducing, C) nipple-sparing, inframammary, and D) nipple-sparing, radial incision.
Figure 2.
Figure 2.
Types of alloplastic implant-based reconstruction: A) Two-stage reconstruction; B) direct-to-implant reconstruction.
Figure 3.
Figure 3.
Autologous breast reconstruction: A) and B) abdominal-based reconstruction; and C) latissimus dorsi reconstruction.
Figure 4.
Figure 4.
Fat grafting for lumpectomy defect reconstruction
Figure 5.
Figure 5.
Oncoplastic breast reduction
Figure 6.
Figure 6.
Nipple areolar reconstruction: A) Three-dimensional tattoo, B) nipple reconstruction with local flap, and C) tattoo following nipple reconstruction.
See this image and copyright information in PMC

Comment in

  • Not my quality.
    Upfold J. Upfold J. Can Fam Physician. 2018 Sep;64(9):634. Can Fam Physician. 2018. PMID: 30209088 Free PMC article. No abstract available.

References

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    1. Canadian Cancer Society . Breast cancer statistics. Toronto, ON: Canadian Cancer Society; Available from: www.cancer.ca/en/cancer-information/cancer-type/breast/statistics/?regio.... Accessed 2015 Oct 1.
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    1. Al-Ghazal SK, Fallowfield L, Blamey RW. Comparison of psychological aspects and patient satisfaction following breast conserving surgery, simple mastectomy and breast reconstruction. Eur J Cancer. 2000;36(15):1938–43. - PubMed
    1. Serletti JM, Fosnot J, Nelson JA, Disa JJ, Bucky LP. Breast reconstruction after breast cancer. Plast Reconstr Surg. 2011;127(6):124e–35e. - PubMed

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