Breast reconstruction--past achievements, current status and future goals.

Breast cancer is the most common malignant tumour in women, and more than 5000 new cases are discovered each year in Sweden, this means that one woman in nine will be treated for breast cancer during her lifetime. For unknown reasons, the incidence increases by 1% each year. Partial mastectomy is the most common surgical treatment today, but a large number of women undergo mastectomy--that is, excision of all breast tissue including the nipple-areola complex with or without an axillary biopsy. Radical mastectomy--that is the Halsted mastectomy with excision of the pectoral muscles (51)--is almost never done today, so chest wall defects are smaller than in the early days of breast reconstruction. There is, however, still a demand from patients for good, natural-looking, and longlasting breast reconstructions, and reconstructive surgeons have to search for perfection both in existing methods and also in new methods of breast reconstruction. The purpose of this article is to review this complex subject.