Technical, Psychological, and Economic Aspects of DIEP Flap Breast Reconstruction

In the Western world the incidence of breast cancer (BC) is high. In the Netherlands the lifetime risk for women to develop BC is around 13%, making it the most common form of cancer among women with approximately 12.000 women being diagnosed annually. Also, increasing numbers of women are being identifi ed to be genetically predisposed to develop BC due to a known mutation (e.g., BRCA 1 or 2) or a strong family history. Continuous progress in early detection, diagnostics and treatment of BC have produced signifi cant improvements in disease-free and breast cancer related survival. Despite these advances, mastectomy remains an important surgical option to either adequately manage the disease locally (therapeutic mastectomy) or reduce the signifi cantly increased risk of developing BC in genetically predisposed women (prophylactic mastectomy). This mutilating procedure is a potentially traumatic event in a woman’s life, and a wide range of lasting psychological adjustment problems has been described. Breast reconstruction (BR) is aimed at restoring the amputated breast and thus improving patients’ quality of life and body image after mastectomy. Psychological, social, emotional and functional benefi ts of BR, including improved psychological health, self-esteem, sexuality, and body image have been documented.

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