[Long-term results following breast reconstruction]

A ten-year experience of breast reconstruction (BR) at the Gustave-Roussy Institute (Paris) provides material for a long-term analysis of carcinologic and cosmetic results. Carcinologic results have been studied in a group of 120 breast reconstructions which was matched to a group of 120 mastectomies without BR. No statistical difference was observed both for the overall survival and the disease-free survival in both groups. The percentage of local recurrences in the reconstructed breast was inferior, but not statistically, to the percentage observed in the controls providing a good argument in favour of the BR inocuity. Cosmetic results were analyzed on photographs according to a previously defined scale. They show a 55% percentage of satisfactory results when all the techniques of BR are mixed. A comparison between the cosmetic results according to the technique of BR demonstrates the superiority of the rectus abdominis flap which provides a higher rate of satisfactory results (63%) as compared to the results observed after simple reconstruction (53%) or latissimus dorsi (44%). A psychologic study of 150 BR shows that every patient underwent a specific psychological process called mourning work. The degree of satisfaction is not linked to objective results. Overall, 93% of the groups were satisfied, would do it again and would advise it for others; 7% were dissatisfied for surgical or emotional reasons.