Abstract：
In 2023, 62,000 patients were diagnosed with breast cancer in France. Every year, 22,000 mastectomies are performed. Breast reconstruction (BR) should be an integral part of breast cancer management. Yet the MR rate in France is only 28% within 3 years of mastectomy, of which 14% are immediate breast reconstruction (IBR). The number of contraindications to RMI has steadily declined over the last few decades, although some of them remain definitive, such as inflammatory cancer (T4d). Today, many specialists involved in the management of breast cancer consider that IBR can be proposed in cases where adjuvant chemotherapy and/or radiotherapy is indicated, if it is not expected to delay carcinological management. The surgical team must then inform the patient of all available BR techniques. If a team does not offer a particular technique, the patient should be referred to a center that does. In all cases, the proposal for curative and reparative treatment should be the subject of a multidisciplinary discussion involving, in particular, a surgeon, a radiotherapist and a medical oncologist. When adjuvant radiotherapy is indicated, the patient must be informed of the increased risk of complications and deterioration of the aesthetic result. In this indication, RMI by prosthesis is a validated technique. However, if the patient has a history of radiotherapy, autologous techniques should be preferred. In a context of shared decision-making, the choice of whether or not to undergo MR and the type of technique must ultimately be made by the patient, in agreement with the multidisciplinary team.
摘要：
2023年，法国有62,000名患者被诊断出患有乳腺癌。每年,进行了22,000例乳腺切除术。乳房重建（BR）应该是乳腺癌治疗不可或缺的一部分。然而，在法国，乳房切除术后3年内的MR率仅为28％，其中14%为即时乳房重建(IBR)。在过去的几十年中，RMI的禁忌症数量稳步下降，尽管其中一些仍然是确定的，如炎性癌症（T4d）。今天,许多参与乳腺癌管理的专家认为，在需要辅助化疗和/或放疗的情况下，可以提出IBR，如果预计不会延迟癌症管理。然后，手术团队必须告知患者所有可用的BR技术。如果一个团队没有提供特定的技术，患者应该被转诊到这样做的中心。在所有情况下,治疗和修复治疗的建议应该是多学科讨论的主题，特别是,外科医生,放射治疗师和肿瘤医生.当需要辅助放疗时，必须告知患者并发症风险增加和美学结果恶化。在这个指示中，通过假体进行RMI是一种经过验证的技术。然而,如果病人有放疗史,自体技术应该是首选。在共同决策的背景下，是否接受MR和技术类型的选择最终必须由患者做出，与多学科小组达成一致。
