Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul;32(4):630-637.
doi: 10.1007/s12282-025-01723-5. Epub 2025 May 26.

Immediate breast reconstruction surgery for breast cancer: current status and future directions

Tadahiko Shien  1 , Hiroko Nogi  2 , Akiko Ogiya  3   4 , Makoto Ishitobi  5   6 , Chikako Yamauchi  7 , Ayaka Shimo  8 , Kazutaka Narui  9 , Naomi Nagura  10 , Hirohito Seki  11 , Kaori Terata  12 , Miho Saiga  13 , Tatsuya Uchida  13 , Shinsuke Sasada  14 , Teruhisa Sakurai  15 , Naoki Niikura  16 , Hiroki Mori  17 ; Japanese Breast Cancer Society’s Collaborative Study Group of Scientific Research
Affiliations

Immediate breast reconstruction surgery for breast cancer: current status and future directions

Tadahiko Shien et al. Breast Cancer. 2025 Jul.

Abstract

Background: Immediate breast reconstruction (IBR) has become increasingly recognized in Japan as an important component of breast cancer care, improving patients' quality of life after mastectomy. While the adoption of IBR is growing, the reconstruction rate in Japan remains lower than in Western countries. To clarify the current practice and challenges, the Japanese Breast Cancer Society (JBCS) conducted a nationwide survey.

Methods: We conducted a comprehensive web-based questionnaire survey among all JBCS-certified institutions between December 2020 and February 2021. The survey assessed institutional capabilities, surgical techniques, decision-making criteria for BR, and the integration of adjuvant therapy.

Results: A total of 429 institutions responded, with 72.5% offering BR and 61.7% capable of providing immediate reconstruction. Nipple-sparing mastectomy (NSM) was performed at 73.7% of institutions offering reconstruction. Multidisciplinary conferences with plastic surgeons were held at 70.5% of institutions. Approximately 30% of institutions discontinued IBR if sentinel lymph node metastases were detected intraoperatively, and 62.8% avoided recommending IBR for patients likely to require postoperative radiation therapy. In 94% of institutions, BR did not cause delays in the administration of adjuvant chemotherapy. However, 15% of institutions modified their radiation therapy approach in reconstructed patients. Additionally, 27% of physicians still believed that BR could negatively affect prognosis.

Conclusions: The survey confirmed that IBR is widely performed and feasible in Japan. However, institutional differences, limited access to plastic surgeons, and persistent misconceptions remain significant barriers. Strengthening multidisciplinary collaboration and establishing standardized guidelines will help improve BR rates and patient outcomes in Japan.

Keywords: Breast cancer; Complications; Immediate reconstruction surgery; Prognosis.

PubMed Disclaimer

Conflict of interest statement

Declarations. Conflict of interest: Tadahiko Shien reported the personal speaker fee from Allergan Aesthetics.

Figures

Fig. 1
Fig. 1
Reasons for not performing breast reconstruction after partial mastectomy
Fig. 2
Fig. 2
Institutional practices regarding nipple-sparing mastectomy (NSM). A Do you remove the skin over the tumor? B Do you remove the puncture point of needle biopsy?
Fig. 3
Fig. 3
Institutional decision-making criteria regarding immediate breast reconstruction (IBR) in the presence of sentinel lymph node metastases and recommendations for patients requiring post-mastectomy radiation therapy (PMRT). A Will immediate reconstruction be performed even if metastasis is detected in the sentinel lymph nodes? B Will immediate reconstruction be performed even if postoperative radiation therapy is necessary?
Fig. 4
Fig. 4
Routine postoperative follow-up practices after breast reconstruction
Fig. 5
Fig. 5
Distribution of responsibility for follow-up care after breast reconstruction
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Yamakado R, Ishitobi M, Kondo N, et al. A nationwide survey of perceptions and management patterns regarding breast reconstruction and adjuvant therapy in Japan. Breast Cancer. 2023;30(2):302–8. - PMC - PubMed
    1. Sasada S, Nagura N, Shimo A, et al. Impact of radiation therapy for breast cancer with involved surgical margin after immediate breast reconstruction: A multi-institutional observational study. Eur J Surg Oncol. 2024;50(6):108360. - PubMed
    1. Shiraishi M, Sowa Y, Inafuku N. Long-term survey of sexual well-being after breast reconstruction using the BREAST-Q in the Japanese population. Asian J Surg. 2023;46(1):150–5. - PubMed
    1. Ogiya A, Nagura N, Shimo A, et al. Long-term outcomes of breast cancer patients with local recurrence after mastectomy undergoing immediate breast reconstruction: a retrospective multi-institutional study of 4153 cases. Ann Surg Oncol. 2023;30(11):6532–40. - PubMed
    1. Seki H, Ogiya A, Nagura N, et al. Prognosis of isolated locoregional recurrence after early breast cancer with immediate breast reconstruction surgery: a retrospective multi-institutional study. Breast Cancer. 2024;31(5):935–44. - PubMed

LinkOut - more resources