Rekonstrukce prsou u pacientek s BRCA mutací a karcinomem prsu - náš přístup
|Title in English
|Breast reconstruction in patients with BRCA mutation and breast cancer - our approach
|Year of publication
|MU Faculty or unit
|Breast cancer is the most common cancer in the Czech Republic in women. There is no other tumor problem where surgical treatment has undergone such revolutionary changes. Oncoplastic surgery has expanded the possibilities of breast oncological surgery, which enables procedures that are sufficiently radical and yet with a very good cosmetic effect. In the early stages of breast tumors, it even makes it possible to avoid chest radiotherapy, which is necessary in the case of partial resections to achieve sufficient local control of the tumor. The work builds on the many years of experience of our workplace with the diagnosis and treatment of breast cancer in women. We use the possibility of immediate breast reconstruction at the same time with subcutaneous and skin-saving mastectomy. We solve the reconstruction either with an expander and at the second time by inserting a silicone implant, or directly by inserting the implant alone or in combination with the use of autologous tissue, depending on how further oncological treatment (chemotherapy or radiotherapy) is planned. In the period from September 2016 to May 2020, we performed 97 reconstructive surgeries on patients with breast cancer and BRCA mutations at our workplace. Of these, 65 were untreated tumors with immediate reconstruction. We inserted the expander in 32 women with locally advanced tumors with the need for subsequent radiotherapy. Implants were used in 79 cases and tissue reconstruction in 12 cases. All patients are still alive. Complications of performance were in 8 women. In five of them, the implant had to be removed for infection. Patients continue to be monitored by an oncology clinic, recurrences have not yet been recorded, and we have not seen any late complications. Conclusion. Breast reconstruction is a comprehensive set of techniques by which any patient can develop a breast so that it does not depend on an epithelium. This is a multi-step process, not just one operation. There is a greater risk of complications in patients with locally advanced disease who undergo neoadjuvant chemotherapy and then radiotherapy.