Abstract：
BACKGROUND: The landscape of breast reconstruction has changed significantly with a shift in focus to include the restoration of a patient\'s quality of life after cancer. Reconstructive options can be divided into alloplastic (implant based) and autologous (tissue based). This paper aims to provide a current educational summary regarding implant-based reconstruction after breast cancer surgery and review the current literature.
METHODS: A review of the literature was conducted utilising standard PRISMA flowchart. Databases searched included Pubmed, EMBASE, and MEDLINE.
RESULTS: Current practice is explored within the text, including types of implants, indications, and surgical approaches. Heterogenous cohorts, surgical technique variation, and selection bias can make comparison of the literature challenging. The major evidence reviews of implant-based reconstruction topics are discussed including, ADM use, radiotherapy, and complications. Despite the benefits of autologous reconstruction, implant-based techniques still represent a significant proportion of reconstructive breast procedures. However, implant-reconstruction is not without its risks and limitations and, with such variety in practice, there remains a lack of high-quality evidence guiding practice. Most importantly, patients need to be counselled about the pros and cons of each choice, particularly with the increasing utilisation of radiotherapy post-reconstruction. Ultimately, the patient and surgeon should reach a decision in full knowledge of the risks and potential outcomes.
CONCLUSIONS: Further research is required into implant-based reconstructive therapy, which will allow a greater consensus for management and a pathway for both surgeons and patients.
METHODS: A review of the literature was conducted utilising standard PRISMA flowchart. Databases searched included Pubmed, EMBASE, and MEDLINE.
RESULTS: Current practice is explored within the text, including types of implants, indications, and surgical approaches. Heterogenous cohorts, surgical technique variation, and selection bias can make comparison of the literature challenging. The major evidence reviews of implant-based reconstruction topics are discussed including, ADM use, radiotherapy, and complications. Despite the benefits of autologous reconstruction, implant-based techniques still represent a significant proportion of reconstructive breast procedures. However, implant-reconstruction is not without its risks and limitations and, with such variety in practice, there remains a lack of high-quality evidence guiding practice. Most importantly, patients need to be counselled about the pros and cons of each choice, particularly with the increasing utilisation of radiotherapy post-reconstruction. Ultimately, the patient and surgeon should reach a decision in full knowledge of the risks and potential outcomes.
CONCLUSIONS: Further research is required into implant-based reconstructive therapy, which will allow a greater consensus for management and a pathway for both surgeons and patients.
摘要：
背景：随着焦点的转移，乳房重建的前景发生了显着变化，包括癌症后患者生活质量的恢复。重建选项可分为同种异体(基于植入物)和自体(基于组织)。本文旨在提供有关乳腺癌手术后基于植入物的重建的最新教育摘要，并回顾当前文献。
方法：使用标准PRISMA流程图对文献进行综述。搜索的数据库包括Pubmed、EMBASE,和MEDLINE。
结果：本文探讨了当前的实践，包括植入物的类型，适应症,和手术方法。异类队列，手术技术变异，选择偏差会使文献比较具有挑战性。讨论了基于植入物的重建主题的主要证据综述，包括，ADM使用，放射治疗,和并发症。尽管自体重建有好处，以植入为基础的技术仍然占乳房重建手术的很大比例。然而,植入物重建并非没有其风险和局限性，在实践中如此多样化，仍然缺乏高质量的证据指导实践。最重要的是,需要向患者咨询每种选择的利弊，特别是随着放射治疗后重建的使用增加。最终,患者和外科医生应在充分了解风险和潜在结局的情况下做出决定.
结论：需要对基于植入物的重建治疗进行进一步研究，这将使管理达成更大的共识，并为外科医生和患者提供一条途径。
方法：使用标准PRISMA流程图对文献进行综述。搜索的数据库包括Pubmed、EMBASE,和MEDLINE。
结果：本文探讨了当前的实践，包括植入物的类型，适应症,和手术方法。异类队列，手术技术变异，选择偏差会使文献比较具有挑战性。讨论了基于植入物的重建主题的主要证据综述，包括，ADM使用，放射治疗,和并发症。尽管自体重建有好处，以植入为基础的技术仍然占乳房重建手术的很大比例。然而,植入物重建并非没有其风险和局限性，在实践中如此多样化，仍然缺乏高质量的证据指导实践。最重要的是,需要向患者咨询每种选择的利弊，特别是随着放射治疗后重建的使用增加。最终,患者和外科医生应在充分了解风险和潜在结局的情况下做出决定.
结论：需要对基于植入物的重建治疗进行进一步研究，这将使管理达成更大的共识，并为外科医生和患者提供一条途径。
