Breast Cancer Local Recurrence After Breast Reconstruction

Abstract

The primary aim of surgery in breast cancer is to achieve local control of disease. Secondly, improving quality of life and patient satisfaction is of utmost importance. While the positive effect of postmastectomy reconstruction on the psychological well-being of women with breast cancer has been demonstrated, evidence-based data on its oncological safety remain sparse. There is concern that the presence of autologous tissue or an implant may mask locoregional recurrence. Furthermore, there is little agreement on the appropriateness of routine radiological surveillance of these patients as well as on the surgical treatment of locoregional recurrence. We attempt to review the impact of breast reconstruction on the incidence and detection of locoregional recurrence and discuss treatment options.

Zusammenfassung

Das vorrangige Ziel jeder Operation bei Brustkrebs ist, lokale Tumorfreiheit zu errreichen. Darüber ist die Verbesserung der Lebensqualität und die Zufriedenheit der Patientinnen von höchster Bedeutung. Obwohl der positive Effekt der Brustrekonstruktion auf das psychische Wohlbefinden der betroffenen Frauen nachgewiesen wurde, gibt es wenig evidenzbasierte Literatur über die onkologische Sicherheit dieser Operationen. Es bestehen insbesondere Bedenken hinsichtlich Maskierung eines Lokalrezidives nach Prothesenimplantation oder Lappenplastik. Außerdem gibt es bislang keine übereinstimmenden Richtlinien hinsichtlich postoperativer radiologischer Verlaufskontrollen und therapeutischen Vorgehens bei Lokalrezidiv. In diesem Übersichtsartikel diskutieren wir Inzidenz und Diagnose von Lokalrezidiven nach Mastektomie und Brustrekonstruktion sowie mögliche therapeutische Strategien.

Key words

breast reconstruction - recurrence - imaging procedures - expert evaluation

Schlüsselwörter

Brustrekonstruktion - Rezidiv - bildgebende Verfahren - Begutachtung

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1 Both authors contributed equally to this article.