Authors' objectives: In the context of the medical control of healthcare spending, the aim of this assessment requested by the Caisse nationale d'assurance maladie des travailleurs salariés (CNAMTS [National Health Insurance fund for salaried workers]) is to specify the indications, the place of and conditions for carrying out mastoplasty and mastopexy procedures as part of the symmetrisation of the contralateral breast following cancer surgery.

Authors' recommendations: • The prevention and correction of breast asymmetry is an integral part of the surgical management of breast cancer. Thus, mammaplasty procedures (mastoplasty or mastopexy) on the contralateral breast for symmetrisation purposes are indicated in all situations where there is asymmetry between the breasts, whatever its nature and extent, as a result of the therapeutic management of breast cancer. • The decision on symmetrisation is taken jointly by the patient and the surgeon. Symmetrisation of the contralateral breast can be either immediate or delayed. Symmetrisation procedures on the contralateral breast are indicated irrespective of the time that has elapsed since the initial therapeutic procedure. • The surgeon responsible for the management of a breast cancer patient must have expertise in both cancer surgery and plastic surgery. • The patient must be informed by the surgeon of all the mammaplasty techniques applicable to her situation, even if they are not practiced by the surgeon or the health facility consulted. • It is also necessary to ensure that access to mammaplasty techniques on site or by agreement is guaranteed and that clear information is given to patients when these techniques are proposed in the course of the care pathway. • It seems important to improve the content and recognition of existing training in breast surgery, in particular by including a minimum practical training element.

Project Status: Completed

Year Published: 2012

URL for published report: http://www.has-sante.fr/portail/upload/docs/application/pdf/2012-06/rapport_symetrisation_mammaire.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: France

Organisation Name: Haute Autorité de Santé

Contact Address: 2 avenue du Stade de France, 93218 Saint-Denis La Plaine Cedex, France. Tel: +33 01 55 93 71 88; Fax: +33 01 55 93 74 35;

Contact Name: has.seap.secretariat@has-sante.fr

Contact Email: has.seap.secretariat@has-sante.fr