Immediate breast reconstruction by prosthesis: A safe technique for extensive intraductal and microinvasive carcinomas

Background: Immediate breast reconstruction (IBR) by prosthesis is frequently proposed after mastectomy. However, due to the morbidity of this operation, especially the early implant removal rate, its indications remain controversial, Methods: We have performed 141 IBR by prosthesis (saline or gel-filled implant, tissue expander) in a homogeneous population of patients with extensive intraductal or microinvasive carcinoma, diagnosed after an initial local excision. This prospective study was designed to assess the feasibility and morbidity of IBR for an ''ideal'' population, allowing wide cutaneous preservation, without preoperative or postoperative treatment. Results: The early prosthesis removal rate (<2 months) was 0.7%, with only 2.1% of early surgical revisions and 3% of lymphoceles. Cutaneous complications (5%) were significantly correlated with the type of incision. Cosmetic results at 1 year were good or very good in 66% of cases, similar to the percentage observed after delayed reconstruction by prosthesis. Conclusions: In this selected population, IBR by prosthesis did not induce any additional morbidity compared with mastectomy without reconstruction, IBR by prosthesis can be systematically proposed in cases of extensive intraductal or microinvasive carcinoma.