Aesthetic and reconstruction considerations in oncologic breast surgery.

i a w o a reast cancer is the most common malignancy seen in omen in the US; with an age-adjusted incidence of ore than 120 per 100,000 American women, it is reorted to affect at least 1 in 9 over an 85-year lifetime. dvances in breast health awareness, with improved creening, earlier detection of disease, and more effective ystemic therapy, have resulted in considerable declines n breast cancer mortality rates, by approximately 2% er year. These improvements in outcomes have motiated efforts to offer comparable progress in survivorhip issues such as quality of life and aesthetically enanced breast cancer surgery. Breast conservation urgery (BCS) and breast reconstruction represent major xamples of these efforts. BCS has been definitively shown to be an oncologially safe treatment for breast cancer in multiple propective randomized trials conducted internationally, nd it has been deemed by the National Institutes of ealth preferable to mastectomy in appropriately seected patients because of the cosmetic benefits. For atients who undergo mastectomy, the technology of reast reconstruction can reverse some of the psychosoial and physical impact of this disfiguring operation, nd access barriers related to cost have been partly overome by the 1998 Women’s Health and Cancer Rights ct, a federal law mandating insurance coverage for masectomy reconstruction. Nonetheless, several reports ave indicated that both BCS and breast reconstruction re underused in the US. There are additional, easily verlooked concepts in general surgical and reconstrucive techniques that can improve the symmetry, comfort, nd appearance of patients undergoing all forms of reast cancer surgery. The goal of this review article was o summarize some of the preoperative, intraoperative,