A Retrospective Study of Breast Reconstruction in Northern Ontario

Abstract

Abstract Background: Breast reconstruction is often the final step for women diagnosed with breast cancer. For many in Northern Ontario, lack of access to a plastic surgeon is a significant barrier to breast reconstruction surgery. The aim of this study is to characterize the types of breast reconstruction surgeries performed in Northern Ontario by describing patient demographics and identifying the most commonly performed procedures. Materials and Methods: This is a retrospective review of patient electronic medical records who received reconstructive breast surgery in Thunder Bay between January 2013 and August 2019. Outcome measures included place of residence, clinicopathologic characteristics, complications, timing of reconstruction, type of procedure, and adjunctive procedures. Results: A total of 95 breast reconstruction procedures were performed, 37 patients underwent immediate reconstruction postmastectomy and 58 patients had reconstruction delayed. The average distance traveled by patients was 253.39 km. Of these patients, 36 had tissue expander with implants, 11 each received 1-step implants and autologous flaps with implants, 4 underwent a resection-reduction approach, 13 received a delayed balancing procedure, 9 received fat grafting, 3 received nipple reconstruction, and 8 were referred elsewhere. Some postsurgical complications included infections, seromas, hematomas, tissue expander exposures, T-junction wound breakdown, flap necrosis, implant failure, and blocked drains. Conclusion: Providing information to physicians and patients about patient trends within their population can not only help improve referral rates but also can enhance patient-provider communication and increase patient involvement in care.