Breast cancer management: a review of the role of plastic and reconstructive surgery

Background: In developing countries, late presentation of breast cancer is a common problem because of the fear of losing the breast as well as ignorance of post mastectomy reconstructive options. In Nigeria, about two-third of patients with this disease present late at a time when therapy offers minimal benefit. Purpose: This review is aimed at summarizing the role of the plastic surgeon in reducing the problem of mutilating surgery in breast cancer and alert surgeons in the developing countries on the need to educate women on various reconstructive options that improve the look and psychological/self image problems that often accompany mastectomy. Materials and methods: Literature review using Medline, Pubmed, AJOL and Google search engines was carried out. Result: Over 38,000 articles and abstracts were noted as discussing the subject matter of breast cancer and reconstructive procedures. There is a dearth of write ups from Africa on breast reconstruction. Several options exist for the reconstructive surgeon to assist in reducing the psychological and image problems that usually accompany mastectomy in breast cancer patients especially in developing countries. Many of the options are discussed in this paper. Conclusion: The place of an oncoplastic surgeon is important especially in the developing world where plastic surgeons are few and the general work load is heavy. Education of women on breast reconstructive options will encourage early presentation and better prognosis. Key words: Breast cancer, post mastectomy breast reconstruction, late presentation of breast cancer, developing countries.