الفهرس 
Surgical Anatomy of the Female BreastOnly 14 pages are availabe for public view
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Abstract
Breast cancer is the most common form of cancer and is the second leading cause of cancer death.
The female breast is intimately associated with a woman’s self-esteem, sexuality, and interpersonal relations. The response to the impact of breast cancervaries widely among women.
The management of patients with breast cancer has undergone significant evolution over the past two decades as a result of a better understanding of the biologic behavior of breast cancer, advances in adjuvant chemotherapy and hormonal therapy, advances in radiographic detection of early-stage breast cancer, and the implementation of breast conservation therapy and sentinel lymph node biopsy. The vast majority of breast cancers diagnosed today at early stage. The use of routine screening mammography and increased breast cancer awareness are primarily responsible for the trend towards earlier diagnosis. Although radical and modified radical mastectomies have been the mainstay treatment for early-stage breast cancer for decades, breast-conserving therapy has become the preferred method of treatment for appropriate patients with early-stage breast cancer. As a result, disfiguring outcomes have become less common.
In recent years, there has been growing emphasis on minimizing the disfigurement associated with the treatment of breast cancer. This trend has manifested in three major areas: increased popularity of breast conservation therapy, development of techniques to reduce deformity following lumpectomy and segmentectomy, and major advances in post-mastectomy reconstruction.
Immediate reconstruction has psychological benefit to the patient by decreasing any feelings of physical mutilation and diminished femininity. Studies have demonstrated that women with immediate breast reconstruction may experience less psychosocial morbidity than women who receive mastectomy alone.
Techniques in breast reconstruction have continued to evolve to provide breast cancer patients options with less donor morbidity and more durable implantable devices. Over the past decade, practice patterns have gradually trended towards more immediate reconstructions for non-irradiated patients owing to superior esthetic outcome, a more facilitating recovery, and the ability to maintain an equivalent oncologic outcome. Current techniques and materials may provide all patients, regardless of age, stage, or previous treatment, outcomes that simulate the patient’s expectations and desires.
Based on several factors including patient desire, oncologic adjuvant treatment requirements, patient risk factors such as obesity, radiation and cigarette smoking, as well as breast size, body habitus and athletic interests. The primary goal of breast reconstuction is to create a long lasting, naturally appearing breast which matches the opposite breast in size, contour, and feel. This goal should be achieved with the least possible morbidity at the donor site.
There are currently several options available which include reconstruction with non autologus breast tissue or autologous tissue, or both. Implant based techniques are a simple and effective method of breast reconstruction, but they may not be suitable for all patients, particularly those who need or have had radiotherapy. Autologous methods in contrast are more surgically demanding, but they consistently yield better aesthetic results than non-autologous methods, particularly when combined with skin sparing mastectomy.
Creating a nipple-areolar complex is an integral part of the breast reconstruction. It enhances the final cosmetic result and creates a more natural looking reconstructed breast. It is typically performed 3 months after the mound reconstruction.