Current state of breast reconstructive surgery

The review of the literature is devoted to the issues of reconstructive surgery after mastectomy for cancer. The authors studied the origins of reconstructive breast surgery, the main directions of development and the current state, evaluated the role of reconstructive breast surgery in the prevention of breast cancer, complex treatment of breast diseases, and identified ways to improve the quality of life of women with breast diseases. An increase in the incidence of cancer in the general population, and breast cancer in women, was noted. Possible options for surgical treatment of breast cancer, both in isolation and in combination and complex treatment, are considered. The terms of reconstructive and reconstructive operations after mastectomy were studied. The oncological safety of organ-preserving treatment with simultaneous breast reconstruction was evaluated. The methods of reconstruction of the mammary glands, both previously used and modern, using various alloplastic materials, are considered. A comparative analysis of the effectiveness of the use of various alloplastic and autoplastic materials for breast reconstruction, possible postoperative complications. The directions of development of reconstructive breast surgery are determined: restoration of the shape and texture of the breast, and not only its volume; restoration of the inframammary fold of the breast, and not only its contours, while preserving the nipple-areolar complex. Analyzing the current literature, it can be concluded that in reconstructive breast surgery, the main emphasis is on understanding what the patient wants to get as a result of the operation performed on her, and, in accordance with the desired end result, using the most optimal way to restore or correct the breast. At the same time, the important components of success are the desire to minimize the surgical trauma, the number of corrective operations, the optimization of the rehabilitation period, the reduction of financial and economic costs, and the analysis of the degree of patient satisfaction with the results of the treatment. The literature review was carried out in accordance with the international recommendations of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and included electronic databases MEDLINE and SCOPUS and Russian-language sources of modern literature. To include more patients, full-text articles, references to modern literature sources, and abstracts were analyzed.