TY  - JOUR
T1  - REconstructive breast implantation after mastectomy for breast cancer—invited critique
AU  - Singh NK
Y1  - 2005/12/01
N1  - 10.1001/archsurg.140.12.1160
JO  - Archives of Surgery
SP  - 1160
EP  - 1161
VL  - 140
IS  - 12
N2  - 
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.

SN  - 0004-0010
M3  - doi: 10.1001/archsurg.140.12.1160
UR  - http://dx.doi.org/10.1001/archsurg.140.12.1160
ER  -