The value of the TRAM flap breast reconstruction in patients with breast carcinoma


Klin Onkol 2004; 17(6): 208-212.

Backgrounds:Breast reconstruction after mastectomy with TRAM (transversus rectus abdominis musculocutanneous) flap became a standard in many plastic surgery units in Czech Republic. However, breast reconstruction is performed in a small percentage of potential candidates. The value of this procedure is unknown for patients with breast carcinoma and is questionable in patients whose metastatic disease develops in the postoperative period.
Design: 1. We attempted to measure the value of breast reconstruction by defining the number of years of life following breast reconstruction that would compensate all negatives associated with the reconstructive surgery and recovery. 2. We compared the value of reconstruction with the aesthetic result for each patient.
Subjects: 78 patients who underwent breast reconstruction after mastectomy using TRAM flap at the Clinic of Plastic and Aesthetic Surgery, St. Anna’s Faculty Hospital in Brno during period of years 1990-1996.
Method: A questionnaire was sent that consisted of 8 questions which should define the length of life with reconstructed breast that would compensate all negatives associated with surgery and recovery. We have compared this value with the objective evaluation of the aesthetic result of each patient.
Result and Conclusion: 1. We have found that most commonly 2,5 years of life following the breast reconstruction were worth the surgery and recovery. This value was very individual but, when compared with the life expectancy, it may help determine the indication for breast reconstruction in patients with poor prognosis of survival of the disease. 2. Nearly all patients appreciate reconstruction highly and positively and they would recommended it to the other patients with breast cancer. 3. There was a substantially weak correlation between the value of reconstruction and the objective evaluation of aesthetic result of each patient. Most patients appreciate mainly restauration of basic symetry of their breast.

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