الفهرس 
ANATOMY OF FEMALE BREASTOnly 14 pages are availabe for public view
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Abstract
Breast cancer is currently the top cancer in women worldwide. Techniques that are used in treatment of this disease have evolved through the years to eradicate the tumor cells completely while restoring the patients’ pre-disease state. Breast conservative surgery has gained enormous popularity because it appears to eradicate breast cancer without increased recurrence at primary site, yet preserving a maximal volume of breast tissue.
Breast conservation therapy preserves the breast and often reduces the demand for reconstruction of post mastectomy defects. Some women undergo partial mastectomy with radiation and maintain excellent breast symmetry and contouring. Others show more noticeable deformities that might require secondary revision or completion mastectomy with reconstruction.
Breast reconstruction is a vital component in the management of breast cancer. Reconstruction lessens the psychological and physical burden of the diagnosis.
A spectrum of techniques is available from which the patient and surgeon can choose. These techniques can involve non autologus (breast implants), autologous tissue, or both.
Each surgeon should discuss with the patient about the advantages and disadvantages of all methods of breast reconstruction to assist her to determine the most appropriate one. The main point is that all women who undergo mastectomy should be offered reconstruction in case it meets their personal needs and alleviates some of the psychological strain of malignancy.
Nipple and areolar reconstruction is an important component of breast reconstruction; the nipple and areola transforms the reconstructed mound into a breast. When breast reconstruction is done correctly and the nipple-areola reconstruction is attractive, the overall result is pleasing and natural.
Both implant and autologous tissue reconstructive techniques have been proven safe oncologically. Breast cancer can recur with or without surgery; it is usually noted superficially along the mastectomy scar line. If a recurrence is being detected late due to reconstruction, long-term survival is not altered by the surgery.
Timing of breast reconstruction after mastectomy involves many factors that are important in choosing between three options immediate, delayed, or “delayed-immediate” reconstruction. When possible, immediate reconstruction is preferred because it has not shown to increase oncologic risk, nor delay adjuvant therapy, provides for better aesthetic outcomes, and provides for less depression. It is also more cost-effective.
This essay offers an algorithm for management of breast reconstruction (timing and choosing the technique).