Reconstructive measures in local recurrence after breast saving therapy of breast cancer

Local recurrence after breast preserving treatment of breast cancer will usually be treated by simple mastectomy. Safe immediate reconstruction is only possible by use of a musculocutaneous flap, the latissimus dorsi flap or better by the rectus abdominis musculocutaneous flap in it's vertical (VRAM) or transverse (TRAM) variation. As a sequel of the irradiation, one stage reconstruction with a simple submuscular implant or an expander prosthesis has a higher complication rate. Personal experience with 42 rectus flaps is reported. The rate of total necrosis was 5%, in one patient a late desmoid tumor was found in the donor area.