Reconstrucción inmediata con prótesis tras mastectomía en la enfermedad benigna y maligna de la mama

Introduction. Although most breast tumors in early stages are treated by conservative surgery, modified radical mastectomy is still the procedure most often performed in breast cancer patients. The use of this mutilative surgery in increasingly younger patients implies the need for reconstruction.
Patients and methods. Between 1990 and 1996, 35 patients underwent placement of 41 breast implants, 38 immediately after cancer surgery and 2 delayed. Twenty-three were Becker implants and 17 were anatomical or biodimensional prostheses, placed in subpectoral position in 32 cases and in the subcutaneous layer in 9. The indication for mastectomy (29 modified mastectomies, 10 subcutaneous mastectomies and one total mastectomy) was the presence of malignant disease in 32 cases, fibrocystic breast disease in 7 and phyllodes tumor in one.
Results. After a mean follow-up period of 46 months (range: 12 to 80 months), we detected the presence of local recurrence at 4 years. The incidence of complications was 27.5%; the most common ones were mild capsular retraction in 2 cases, infection (and implant removal) in 2, severe capsular retraction (and implant removal) in 4, and migration to axilla (and replacement) in one. Eight implants had to be removed in 8 cases (20%). The cosmetic results were good or excellent in 61% of cases, fair in 2.4% and poor in 14.6%.
Conclusions. We obtained good cosmetic results in breast reconstruction after radical breast cancer resection, regardless of the subcutaneous or subpectoral location. This procedure requires a prolonged postoperative hospital stay. The presence of contralateral breast ptosis produces asymmetry requiring some type of reconstructive surgery