Breast cancer recurrence after reconstruction: know thine enemy
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Elizabeth A. Brett1, Matthias M. Aitzetmüller1, Matthias A. Sauter1, Georg M. Huemer2, Hans-Günther Machens1 and Dominik Duscher1
1Department of Plastic and Hand Surgery, Technical University of Munich, Munich 81675, Germany
2Section of Plastic and Reconstructive Surgery, Kepler University Hospital Linz, Linz 4020, Austria
Dominik Duscher, email: [email protected]
Keywords: breast cancer recurrence; reconstructive surgery; flaps; fat grafting; breast implants
Received: February 06, 2018 Accepted: May 19, 2018 Published: June 12, 2018
Breast reconstruction proceeding cancer treatment carries risk, regardless of the type of surgery. From fat grafting, to flap placement, to implants, there is no guarantee that reconstruction will not stimulate breast cancer recurrence. Research in this field is clearly divided into two parts: scientific interventional studies and clinical retrospective evidence. The reconstructive procedure offers hypoxia, a wound microenvironment, bacterial load, adipose derived stem cells; agents shown experimentally to cause increased cancer cell activity. This is compelling scientific evidence which serves to bring uncertainty and fear to the reconstructive procedure. In the absence of clinical evidence, this laboratory literature landscape is now informing surgical choices. Curiously, clinical studies have not shown a clear link between breast cancer recurrence and reconstructive surgery. Where does that leave us? This review aims to analyze the science and the surgery, thereby understanding the oncological fear which accompanies breast cancer reconstruction.
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