[Immediate breast reconstruction with the transverse rectus abdominis musculocutaneous flap (TRAM-flap)]

The surgical treatment of breast cancer shows a recent trend toward breast-saving procedures, in consideration of quality and body image. Surgeons who performed mastectomy, however, have not taken aggressive approaches to reconstructive surgery, leaving this to plastic surgeons. We adopted the transverse rectus abdominis musculocutaneous flap (TRAM-flap) for breast reconstruction in 1988 and performed immediate breast reconstructions in 37 cases. There were no major complications, and good cosmetic results were obtained. For general surgeons, this excellent technique can safely cope with tissue defects in radical mastectomy, as well as modified radical mastectomy. Immediate breast reconstruction with this technique will be an integral part of breast cancer surgery in company with breast-saving surgery.