Psychological benefits of immediate breast reconstruction.

Immediate breast reconstruction after mastectomy in patients with locally advanced breast cancer is safe and provides important psychological benefits, maintains Mark Sultan, assistant professor of surgery, Columbia-Presbyterian Medical Center, New York. Immediate reconstruction routinely is offered to women with early-stage breast cancer, but not to those with more advanced disease. Oncologists have been reluctant to offer immediate reconstruction to the latter because such patients require preoperative chemotherapy, which can cause complications with wound healing and infections, possibly delaying the resumption of postoperative chemotherapy. "However, since the psychological, practical, and technical benefits that immediate reconstruction provides in early-stage disease are so well-established, we felt it necessary to attempt to expand its use to those with locally advanced disease."

In his study, 22 patients with locally advanced breast cancer (stage IIB or III) underwent mastectomy and immediate breast reconstruction. Eight received saline-filled implants, while 13 were reconstructed with their own tissue and one with an implant and her own tissue. Three of the women suffered minor postoperative complications...