Invited Critique |

Reconstructive Breast Implantation After Mastectomy for Breast Cancer—Invited Critique

Navin K. Singh, MD
Arch Surg. 2005;140(12):1160-1161. doi:10.1001/archsurg.140.12.1160.
Text Size: A A A
Published online


Studies from the United States demonstrate that postmastectomy immediate and early reconstruction is underutilized, with overall reconstruction rates of approximately 15% of mastectomies, with a significant regional variation. This represents a 147% increase from 1992, which is partly attributable to the Women’s Health and Cancer Rights Act of 1998 that mandates insurance coverage for reconstruction.1 The Canadian experience, representing a disparate health care outlook and financing model, yields comparably low reconstruction rates of approximately 8%.2,3 In many patients, autologous tissue such as TRAM [transverse rectus abdominis myocutaneous], free TRAM, or DIEP [muscle sparing, using the superficial epigastric artery or the inferior epigastric artery] flaps may afford superior results in the long term.4 However, based on patient preference or unsuitability for autologous tissue reconstruction, about 24% of these patients undergo implant-based reconstruction with saline, silicone, or dual-chambered implants. Countless studies demonstrate excellent outcomes in terms of patient satisfaction, self-image improvement, and overall safety using breast implantation in this patient subpopulation. Sound methods, such as the Medical Outcomes Study 36-Item Short-Form Health Survey, have been used to establish these international practice norms.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Topics
PubMed Articles