An objective analysis of immediate simultaneous reconstruction in the treatment of primary XXXX .

@entity5 @entity1 @entity0 @entity66
In January 1977, the authors developed a protocol to test the advisability and feasibility of immediate simultaneous reconstruction in the treatment of primary @entity0 . Initial concerns included the morbidity of the procedure, the potential for compromise of cure and of adjuvant @entity5 therapy, and the aesthetic acceptability of immediate reconstruction both to the @entity1 and to the surgeon. All @entity1 were seen preoperatively by both the oncologic surgeon (T.G.F.) and the plastic and reconstructive surgeon, (R.B.N.), and underwent modified radical mastectomy and simultaneous reconstruction. The initial protocol included only those @entity1 with @entity5 1 cm or smaller, but over the last 25 cases the protocol has been expanded to include any @entity1 presenting with clinical Stage I @entity0 . To date, 70 such @entity1 (ages 27-63 years) have undergone immediate simultaneous reconstruction as part of their treatment. Twenty-five @entity1 had evidence of microscopic @entity66 (35.7%). All @entity1 were offered adjuvant therapy, and in no case was therapy delayed beyond 4 weeks postoperatively. Three @entity1 developed complications resulting in loss of implant (4.3%). All @entity1 have been followed at regular intervals, and no @entity1 has been lost to follow-up. In only one @entity1 was there a local recurrence without distant disease. Survival curves are consistent with the stage of the disease. The surgical techniques utilized and the methods of @entity1 selection are discussed. The authors conclude that this is a desirable and viable option in selected @entity1 with primary @entity0 , and that immediate simultaneous reconstruction can be done with an acceptable morbidity and without compromise of @entity5 therapy.
