Which of the following statement(s) is/are true concerning breast reconstruction?

a. The timing of breast reconstruction is of no oncologic significance

c. Maintenance of an effective subpectoral pocket for a breast implant requires preservation of the pectoralis fascia

Breast reconstruction is suitable for any woman who has undergone mastectomy who desires reconstruction. Breast reconstruction may be performed at the time of mastectomy (immediate) or sometime subsequently (delayed) Because the presence of reconstruction may interfere with the accurate planning and administration of radiation therapy, reconstruction is generally delayed if the use of local or regional radiation therapy is anticipated. Otherwise, timing of breast reconstruction is of no oncologic significance. Because most local recurrences occur in the skin’s subcutaneous tissues, the presence of a reconstruction will not interfere with detection. Similarly, a reconstruction does not complicate the administration of chemotherapy.

Breast reconstruction techniques utilize either autogenous tissue or synthetic prostheses to recreate a breast mound. Prosthetic reconstruction is usually accomplished by sub-pectoral placement of a saline-or silicone gel-filled implant. Maintenance of an effective sub-pectoral pocket for an implant requires preservation of the pectoralis fascia and the medial pectoral nerve during mastectomy. The transferase rectus abdominous myocutaneous (TRAM) flap is the autogenous reconstruction of choice. The TRAM operation is complex and time consuming. Despite the magnitude of the procedure, it is still commonly used for immediate reconstruction.