| Category | Immediate breast reconstruction | Delayed breast reconstruction |
|---|---|---|
| Definition | Reconstruction is started in the same operation as the mastectomy | After a mastectomy, reconstruction is done in a separate operation |
| Number and timing of operations |
More than 1 operation is usually needed to complete the reconstruction The total number of operations will vary. It may be affected by factors such as:
Fewer operations may be needed |
More than 1 operation is usually needed to complete the reconstruction The total number of operations will vary. It may be affected by factors such as:
More operations may be needed |
| Breast reconstruction options available |
These will vary depending on personal preferences (such as breast size desired), current body shape, other health conditions, previous operations and lifestyle factors (such as hobbies) Not all hospitals or surgeons can offer all procedures. Travel to a different hospital may be needed for a specific option Options may be available that spare or preserve the breast skin (which may mean less scarring and a more natural look) Limited time to make a decision about options (which may include not having a reconstruction) before surgery |
These will vary depending on personal preferences (such as breast size desired), current body shape, other health conditions, previous operations and lifestyle factors (such as hobbies) Not all hospitals or surgeons can offer all procedures. Travel to a different hospital may be needed for a specific option Certain options that spare or preserve the breast skin may not be available More time to make a decision (which may include not having a reconstruction) and to plan reconstruction |
| Benefits | Breast shape remains, which may help maintain body image and have subsequent psychological benefits |
Lifestyle changes (such as losing weight and taking regular exercise) may be possible, which increase the options and lower the risks of reconstruction surgery Procedures (and associated recovery) can be planned around other commitments |
| Risks |
Surgical complications can occur after any breast reconstruction and will vary by type of procedure and personal risk factors May be lower rates of:
Complications from the mastectomy or axillary surgery can occur during the recovery period |
Surgical complications can occur after any breast reconstruction and will vary by type of procedure and personal risk factors May be lower rates of:
May need to interrupt hormone therapies (tamoxifen) for further surgery |
| Satisfaction | No clear differences in satisfaction with completed reconstructions | No clear differences in satisfaction with completed reconstructions |
| Reconstruction and adjuvant therapy (including radiotherapy and chemotherapy) |
Radiotherapy or chemotherapy can be given but may be delayed if there are complications from the mastectomy or reconstruction Immediate reconstructions using implants may be more affected by radiotherapy than immediate flap reconstructions May need adaptions to scans if a tissue expander is used. For example, may not be able to have MRI scans and may need modified radiotherapy planning | Complications can also occur after mastectomy alone, which may delay chemotherapy or radiotherapy |
From: Early and locally advanced breast cancer
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