COMPARATIVE CHARACTERISTICS OF BREAST RECONSTRUCTION METHODS. LITERATURE REVIEW

Abstract

Introduction. Breast cancer was the most frequently diagnosed cancer worldwide in 2020, with an estimated 2.26 million 
new cases. In Kazakhstan, breast cancer ranks first among newly diagnosed cancers, with 5,101 cases out of 39,077 in 
2022. Radical mastectomy remains the most common surgical intervention, but the resulting physical and psychological 
consequences significantly affect patients' quality of life. Breast reconstruction is essential to restore physical and emotional 
well-being, yet its implementation in Kazakhstan remains limited. 
Objective. To compare global breast reconstruction methods and assess their applicability and relevance in Kazakhstan. 
Search strategy: A literature review was conducted using Web of Science and PubMed. Глубина поиска составила 5 
лет. Reconstruction methods were divided into three groups: (1) tissue implants, (2) pedicle flaps, and (3) microsurgical free 
flaps. The methods were compared based on ease of implementation, cost effectiveness, recovery time, skill requirements, 
oncologic safety, and applicability to regional hospitals. 
Results. Tissue implants provide shorter operative and recovery times but carry risks such as capsular contracture, 
implant migration, and higher infection rates, especially after radiation therapy. Pedicle flaps, including thoracodorsal and 
TRAM flaps, provide robust vascularization and sufficient tissue volume but are associated with donor site morbidity. Free 
flaps, especially DIEP, provide superior aesthetic results but require advanced microsurgical skills and longer operative 
times. Economic analysis revealed higher costs for implant-based reconstruction compared to flap-based methods. 
Conclusion. Each breast reconstruction method has specific advantages and limitations. Implant-based reconstruction 
is faster but is expensive and prone to complications. Pedicle flaps are reliable and cost-effective, while free flaps provide the 
best aesthetic results but require specialized knowledge. Regional hospitals in Kazakhstan should focus on developing 
infrastructure and training programs to provide optimal breast reconstruction services.