Breast reconstruction in patients with BRCA mutation and breast cancer - our approach

Abstract

healthy carriers, is increasing. Newer methods also concern the combination of curative power on one breast and at the same time prophylactic power on the other breast.

Methods: We use the possibility of immediate breast reconstruction at the same time with subcutaneous and skin-saving mastectomy. We solve the reconstruction either with an expander and in the second time by inserting a silicone implant, or directly by inserting the implant alone or in combination with the use of autologous tissue, depending on how further oncological treatment (chemotherapy or radiotherapy) is planned.

Results: Between April 2017 and May 2020, 103 reconstructive surgeries were performed on 58 women with breast cancer and/or BRCA mutations. Of these, there were 52 immediate reconstructions for untreated tumors. A tissue expander was inserted in 27 women (46.6% of the group) with locally advanced tumors and the need for subsequent radiotherapy (18 immediate and 9 delayed reconstructions). Breast implants were used in 52 women (89.7% of the group) in a total of 80 implants. Breast reconstruction of own tissues was performed in 8 women, of which 5 operations within the immediate reconstruction. Postoperative complications occurred in 11 women and 15 corrective procedures were performed (12.7% of operations).

Conclusion: Breast reconstruction is a comprehensive set of techniques by which any patient can develop a breast so that it does not depend on an epithelium. This is a multi-step process, not just one operation. Patients with locally advanced disease who receive neoadjuvant chemotherapy and radiotherapy are at greater risk of complications. With the growing number of breast cancers, the demand for reconstructive procedures, especially immediate reconstructions, is increasing.