Breast reconstruction modality and outcomes after mastectomy

Abstract

BackgroundChoosing a breast reconstructive modality after mastectomy is a critical step involving complex decisions. Postoperative complications can be a significant setback for patients undergoing breast reconstruction. In this study, the results of different reconstructive modalities are recorded and their complications are discussed for further preoperative counseling. Materials and MethodsNinety patients who had undergone breast reconstruction at our institution in the past 5 years were reviewed. Clinical encounters for all reconstruction modalities, namely implant-based, autologous tissue, and combined reconstructions, were assessed. We evaluated several clinical variables, such as type of operation, timing of reconstruction, and early and late complications. ResultsPatients were aged 28–61 years, with a mean age of 44.8 years. The body mass index (BMI) ranged from 16.9 to 31.1 kg/m2, with an average of 22.87 kg/m2. The follow-up duration ranged from 5.6 to 85.9 months, with a mean of 38.3. Thirty-eight, 46, and 6 patients received implant-based reconstruction, autologous reconstruction, and combined reconstruction, respectively. The most common complication recorded in the implant-based group was hematoma (7.9%), whereas re-exploration (6.5%) and abdominal hernia (6.5%) were the most common complications in the autologous tissue reconstruction group. The average age and BMI of the patients who experienced complications were 46.4 years and 22.5 kg/m2, respectively, whereas the average age and BMI for the patients without complications were 44 years and 23 kg/m2, respectively. Complications were most common in patients who underwent adjuvant irradiation and pedicle flap reconstruction (100%). ConclusionIn this small-scale study, we found that an implant-based reconstruction was more frequently performed on older patients. Because of the relatively small average body size and low BMIs of Asian people, obesity is not considered to affect the postoperative complication rate. In addition, postreconstructive irradiation is unlikely to produce additional complications because the patients underwent pedicle flap reconstruction.