Rezidivverhalten und Lebensqualität bei Patientinnen nach Mastektomie und Mastektomie mit Primärrekonstruktion

Purpose: The aim of every breast cancer therapy is to treat the patients as respectful as possible without compromising the safety as indicated by the oncological criteria. If breast-preserving surgery is not possible, different surgical procedures of breast reconstruction after mastectomy are available. In principle, reconstruction can be done at the same time as the mastectomy as a primary reconstruction. It can also be done at a later stage as a secondary reconstruction. We also analysed whether the timepoint of surgery, the surgical technique and the preoperative radiation therapy have an influence on the local recurrence risk, the cosmetic outcome and the quality of life. Material and Methods: We compared local recurrence in a total of 123 breast cancer survivors treated either with mastectomy or mastectomy with primary reconstruction. After surgery the patients filled out a questionnaire that measured the quality of life at different timepoints. Tumor stage and age was recorded in all patients. Results: Based on the analysis of our data coenesthesia and the feeling of being more attractive had improved, however a substantial improvement of quality of life could not be found. The analysis also showed that the quality of treatment and therefore the quality of life could be improved if breast cancer patients were treated in special breast care centers. Conclusion: If oncological-surgical principles are adhered to, primary reconstruction with implants or autotissue has no negative influence on the recurrence risk, the illness-free interval and the overall survival in breast cancer patients. A knowledge of reconstructive surgery of the female breast and critical self-assessment of the surgeon forms the basis for high-quality results after a multimodal therapy. In cases where an adjuvant radiation therapy is necessary, primary reconstruction should not be done at once because of the actinogenic reaction. In such cases an autologous reconstruction alone or in combination with implants is recommended for breast rebuilding.