Absolute Incidence of Major and Minor Complications with Pre-Pectoral Breast Reconstruction with Postmastectomy Radiation

Abstract

<h3>Purpose/Objective(s)</h3> Each year in the US approximately 250,000 women will be diagnosed with invasive breast cancer, and a little over one third will have regional disease (CDC 2020). Many of these women will undergo mastectomy and PMRT and will have to decide on reconstruction. Pre-pectoral implant reconstruction is becoming a more common option with the use of acellular dermal matrices. Jagsi et al (JNCI 2018) reported a 2-year implant-based complication rate of 38.9% with PMRT, however there is a paucity of data on the complication rate specifically for pre-pectoral implant reconstruction with PMRT. We looked to better understand the rate of complication with pre-pectoral complication with PMRT and breast reconstruction as well as provide thorough description of our patient demographics. <h3>Materials/Methods</h3> We retrospectively reviewed all female patients at our institution from 2015-2020 who underwent mastectomy with PMRT, and pre-pectoral implant reconstruction for invasive breast cancer, including: direct to implant, delayed implant, and tissue expander. Our primary outcome was the incidence of reconstruction related complications both minor and major at mean follow up of 2 years. <h3>Results</h3> We identified 34 women who met criteria for our study during this time period. With a mean follow up of 711 days, 20 of 34 women developed a complication for an absolute incidence of 58.8%. 10 were minor complications and 10 were major complications for an absolute incidence of 29.4% for each. Mean time to complication was 305 days. <h3>Conclusion</h3> Our most common reconstruction related complications were capsular contractions (13), however 9 of these were minor complications. This study supports that pre-pectoral reconstruction remains a valid option for women undergoing reconstruction and PMRT, and our results can be used to help counsel them on their rate of complications.