Timing and Type of Breast Reconstruction in Young Breast Cancer Patients

Breast reconstruction is a significant component in the final recovery of young breast cancer patients, who have a longer lifetime after breast cancer treatment, and aesthetic outcome is a main contributor to their quality of life. The appropriate timing and type of breast reconstruction are considerations in young as well as in older breast cancer patient. The choice of the best breast reconstruction is based on oncological needs, surgeon’s advice and patient’s desire and should always be discussed in a multidisciplinary setting. Breast reconstruction can be performed as an immediate procedure, at the time of mastectomy, or as a delayed procedure, after adjuvant chemotherapy and/or radiotherapy. The young breast cancer patient has usually a wider choice of breast reconstruction techniques and is often more demanding and well informed compared to her older counterparts. In general, there are two types of breast reconstruction: autologous reconstruction requiring that tissue coming from the same patient (i.e. free or pedicled flaps) is utilised to reconstruct the breast; implant-based reconstruction implying that a prosthesis (i.e. expander or implants with or without biologic and synthetic meshes) is used to rebuild the breast volume. Radiotherapy plays an important role in choosing the type and timing of breast reconstruction and should always be evaluated in the multidisciplinary meeting in order to discuss all the alternatives to offer the patient.