Post-mastectomy breast reconstruction

#### Summary points Breast cancer is the most common cancer in women, with almost 1.38 million new cases a year worldwide; it accounts for 23% of all cancers and 14% of deaths from cancer.1 However, mortality from breast cancer is declining—increasing numbers of women are long term survivors (>5 years) (currently 549 000 in the United Kingdom).2 3 Surgery remains a mainstay of treatment, either breast conservation or mastectomy, but any breast surgery can greatly alter breast aesthetics and body image. Breast reconstruction restores breast symmetry after a mastectomy by creating a breast mound, similar in size, shape, contour, and “out of bra position” to the contralateral breast. In England and Wales in 2002, about 10% of women had immediate breast reconstruction; by 2009 this had risen to 21%.4 Post-mastectomy breast reconstruction is associated with improved body image, quality of life, self confidence, and wellbeing.5 In this review, we outline the indications for breast reconstruction along with the timing and techniques available to patients after mastectomy. #### Sources and selection criteria We searched Medline, Embase, and the Cochrane collaboration for articles using the keywords “breast reconstruction”. Wherever possible we used evidence from randomised controlled trials, systematic reviews, and meta-analyses from the past five years to provide an up to date review. We also consulted …