Challenging a traditional paradigm: 12-year experience with autologous free flap breast reconstruction for XXXX .

@entity1 @entity393 @entity0
BACKGROUND: @entity0 is a rare but aggressive @entity0 with an overall poor prognosis. Traditionally, reconstruction has not been offered, because of poor long-term survival, the need for multimodality treatment, and complex treatment sequencing. The authors examined the safety and feasibility of free flap breast reconstruction for @entity0 . METHODS: A retrospective analysis of all @entity1 who underwent reconstruction for @entity0 from January of 2000 to December of 2012 was conducted. RESULTS: Of 830 @entity0 @entity1 , 59 (7.1 percent; median age, 48 years; range, 27 to 65 years) underwent free flap reconstruction. All @entity1 received chemotherapy and radiation therapy. Most @entity1 (n = 52) underwent delayed reconstruction. Five @entity1 with a history of prior partial mastectomy and irradiation developed @entity0 and underwent immediate reconstruction following completion mastectomy. Two others underwent immediate chest wall and breast reconstruction following resection. Thirteen @entity1 underwent bilateral reconstruction, and seven required a bipedicled abdominal flap for the unilateral mastectomy defect. Thirty-seven @entity1 (62.7 percent) required revision of the reconstructed breast, and 29 (49.2 percent) had a contralateral balancing procedure to optimize symmetry. Complications occurred in 21 @entity1 (35.6 percent), with one total @entity393 (1.7 percent). The median length of follow-up was 43.9 months; 49 @entity1 (83.1 percent) were alive without evidence of recurrent disease. CONCLUSIONS: Autologous free flap breast reconstruction can be performed safely in @entity0 @entity1 , with acceptable complication rates and without an increased risk for @entity393 . @entity0 should not preclude free flap breast reconstruction. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
