Breast Reconstruction After Cancer Treatment: What is New?

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Background

Reconstructive surgery of the breast after tumour surgery is performed very frequently worldwide, since breast cancer is the most common cancer in women that may affect approximately 1 in 8 women. Nowadays, optimal breast cancer care is almost always offered in dedicated breast cancer centres. Fortunately, current multimodal breast cancer therapy is very effective, particularly in early-stage breast cancer, with overall survival rates exceeding 85%. Notably, prophylactic surgery for high-risk patients and gene-carriers is not included in that count. Consequently, we are confronted with an ever-increasing number of ‘survivors’ for whom quality of life considerations become center-stage and reconstruction indispensable. Though, recent advances in reconstructive surgery have improved clinical outcomes and patient satisfaction that is durable, particularly after large tumorectomies and mastectomy.

To put together a special issue that covers current aspects of reconstructive breast surgery taking into consideration current genetic issues in breast cancer that result in prophylactic mastectomy, knowledge of ideal mastectomy techniques, current concepts in complex breast remodelling after large tumorectomies, novelties in implant-based breast reconstruction as well as in flap-based breast reconstruction. Furthermore, we would like to present new insights that cover the management of failed breast reconstruction, the need for secondary procedures to achieve breast symmetry and finally aspects that are related to enhanced recovery after surgery with its clinical and economic implications, yet taking into consideration a demand for high quality of life after breast reconstruction.

Topics include but are not limited to the following:
1. Genetic mutations and prophylactic mastectomy: What the plastic surgeon needs to know
2. Ideal mastectomy for breast reconstruction
3. Radiotherapy and breast reconstruction: Is there an ideal approach?
4. Role of oncoplastic reconstruction in breast conserving therapy
5. Implant-based breast reconstruction: Is prepectoral reconstruction the new gold standard?
6. Antibiotic prophylaxis and implant-based breast reconstruction: Duration and rationale
7. Are all meshes created equal? Role of allograft, xenograft, and synthetic meshes in implant-based breast reconstruction
8. Reverse expansion and prepectoral hybrid breast reconstruction using autologous fat grafting and implants: Patient selection, surgical technique and clinical outcomes
9. Autologous breast reconstruction: Reconstructive options when the abdomen is not available
10. Microsurgical breast reconstruction with stacked flaps: Surgical sequence and clinical outcome
11. Possibilities after failed breast reconstruction with autologous tissue
12. Secondary procedures to achieve symmetry: How far shall we go?
13. Enhanced recovery after surgery (ERAS) protocols and microsurgical breast reconstruction: Clinical and economic implications
14. Quality of life after breast reconstruction: Is autologous really better that heterologous?

Keywords: Breast reconstruction, implant, flap, oncoplastic, meshes

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