Abstract: 8.50 The Effect Of Axillary Lymph Node Sampling During Mastectomy On Breast Reconstruction Complications

Abstract

INTRODUCTION: Immediate breast reconstruction using tissue expanders is the most common form of breast reconstruction after mastectomy for breast cancer. During mastectomy, axillary lymph nodes are biopsied to stage patients. The purpose of this study is to investigate post-operative complications with respect to extent of lymph node dissection. MATERIALS AND METHODS: Electronic medical records of 282 patients (467 breasts) undergoing mastectomy with immediate reconstruction at our institution from 2010–2012 were reviewed to collect clinical and post-operative data. Charts were analysed to determine the association between the absolute number of axillary lymph nodes removed and post reconstructive incidence of skin necrosis, cellulitis, seroma, and expander removal. Independent sample t test and linear regression were used to analyze data. RESULTS: The overall incidence of all post-operative complications per breast was 23.8%. Breasts in which a complication occurred had a mean of 6 nodes removed versus 4 nodes in uncomplicated breasts (p=0.018). More complications were noted in patients who underwent axillary lymph node dissection (ALND) compared to sentinel lymph node biopsy (SLNB; p=0.008). Expander removal and seroma occurred more frequently in breasts which had a greater number of nodes removed (p=0.006 and p=0.015, respectively). CONCLUSIONS: Axillary lymph node removal of >4 nodes has a higher risk of post-reconstructive complications. Specifically, there is a higher risk of seroma formation and expander loss. ALND has a higher incidence of breast reconstruction complications compared to SLNB.