The current approach to breast reconstruction.

Over the last 30 years, breast reconstruction has become a standard part of the care of the breast cancer patient. While it may take another 30 years for many of the traditional oncologic concerns about reconstruction to be answered, indications are that reconstruction does not alter the patient's prognosis in any way. The increased understanding of breast cancer as a disease which is systemic from early in its course has removed many of the former objections to reconstruction. Reconstruction can be performed after almost any type of mastectomy. Chemotherapy does not interfere with reconstruction, as long as the timing of doses is considered. However, therapeutic radiation does present problems which may preclude reconstruction. Conversely, having had reconstruction does not interfere with later chemo or radiation therapy. The author describes reconstructive options and their relationship to oncological decisions and concerns.