Optimal timing of breast reconstruction - An algorithm for management based on a review of the literature

There is no ideal breast reconstruction suitable for all patients. In early breast cancer, skin-sparing mastectomy with immediate reconstruction provides an excellent outcome in terms of oncologic safety, cosmesis, psychosocial function, and cost. In late stage breast cancer where postoperative radiation will be pursued, consideration to delayed reconstruction should be seriously considered simply due to the deleterious effects of adjuvant radiation on the reconstruction. As breast cancer treatments including reconstruction continue to evolve at a dramatic pace, reconstructive surgeons must be prepared to modify not only techniques employed but philosophies of treatment.