Oncology Frontier: When it comes to reconstruction surgery， what is the suitable time?

　　《肿瘤瞭望》：乳房再造的适宜时机是在什么时候？

　　Dr. Clough : First of all， the plastic surgeon has to be integrated into the multidisciplinary team. That means the discussion has to be made by the surgical oncologist， the medical oncologist， and the plastic surgeon. It is a patient by patient decision. As a general way， if a patient has to be proposed post mastectomy radiotherapy， we would try to avoid immediate reconstruction in most teams as even though it is debated， but most agree that reconstruction will give you worse cosmetic results. If a patient is not due to have post mastectomy radiotherapy， any patient can get an immediate reconstruction. If there is a question mark about post mastectomy radiotherapy then there has to be a discussion with the patient warning her that in case she gets post mastectomy and post reconstruction radiotherapy， a cosmetic result might be mad. Some patients might say that they are fine with it and go on， other patients may say that in that case they would like to defer the reconstruction.

　　Clough教授：首先，所有的整形外科医生均应被整合至乳房再造的多学科团队中来。这就意味着，外科肿瘤学家、医学肿瘤学家及整形外科医生需要就乳房再造时机进行共同讨论，并充分尊重患者意愿。一般来说，如果患者需要在乳房切除术后进行放疗，我们则应尽量避免立即行乳房再造。尽管这方面还存在一定争论，但大多数人赞同“即刻乳房再造可使美容效果变差”。如果患者不需要在乳房切除术后进行放疗，则可立即行乳房再造。若患者乳房切除术后是否放疗仍不确定，则需与患者讨论，告知其一旦进行了乳房切除术，在乳房再造术后进行放疗的美容效果会很差。有些患者可能会说无所谓，愿意即刻乳房再造；而有些患者在这种情况下则希望能推迟乳房再造。