Association Between Postoperative Complications After Immediate Alloplastic Breast Reconstruction and Oncologic Outcome

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Abstract

Mastectomy with immediate reconstruction is associated with increased complications that may negatively impact the oncologic outcome. This retrospective study examined the association between postoperative complications and oncologic outcome in women undergoing immediate alloplastic reconstruction. In a cohort of 186 women with breast cancer, there was a high rate of complications (45%). Postoperative complications were not associated with worse oncologic outcome.

Introduction:

Mastectomy with immediate reconstruction is associated with increased complications when compared with mastectomy without reconstruction. Postoperative complications have been associated with worse oncologic outcome in other cancers. We examined the association between postoperative complications after immediate reconstruction and oncologic outcome.

Methods:

This retrospective study included all women undergoing mastectomy and immediate alloplastic reconstruction for breast cancer between the years 2009 and 2016. Data collected included demographics, cancer and treatment characteristics, type of surgery, postoperative complications, and outcome. Association between postoperative complications and oncologic outcome was examined using Cox regression analysis.

Results:

Between January 2009 and December 2016, 227 women underwent mastectomy with immediate alloplastic reconstruction. One hundred eighty-six (82%) were done for breast cancer. Most (148; 80%) had infiltrating carcinoma. The mean age was 48.8 years (range, 21-77 years). Forty-seven (25%) had a previous history of radiation. Fifty-four (29%) had neoadjuvant treatment. Complications occurred in 83 (45%) of the women. Fifty-five (30%) needed revisional surgery (closure of wound, debridement, exchange or removal of implant, and evacuation of hematoma). Complications were associated with older age and previous radiation history (57% vs. 40% in women with no previous radiation; P = .04). The mean follow-up was 1138 days. Twenty-five (12%) women developed recurrence during follow-up. There was no association between presence of postoperative complications and recurrence of cancer.

Conclusions:

Postoperative complications were not associated with worse oncologic outcome in this study. The study may be limited by the relatively short follow-up.

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