[The cost as an additional variable in the choice among different techniques of postmastectomy breast reconstruction]

Breast reconstruction is an important step for patients after mastectomy. In our Department for immediate reconstruction, smooth or textured temporary tissue expanders filled with saline solution or permanent expandable implants (PEI) with silicon gel saline solution or soyabean oil are usually used. Only in a few selected cases reconstruction using autologous tissues are performed. Delayed reconstruction is performed using autologous tissues: Transversus Rectus Abdominis Myocutaneus Flap (TRAMF) or Latissimus Dorsi flap (LD). The choice between reconstruction with prostheses or muscular flaps depends on previous demolition, local skin condition, contralateral breast size and ptosis, body structure, medical problems, patients' wishes and expectation. Following the legislation defining the privatisation of Italian Health Care Structure and in particular the Decree of December 14, 1994, the need to accurately assess the costs incurred for surgical operations is very important. The aim of this study is to evaluate the clinical limits of each surgical technique and their cost in order to optimize the cost-benefit relationship.