Immediate Breast Reconstruction in the Previously Augmented Patient

Abstract

Women who had undergone previous breast augmentation represent a unique subset of patients presenting for breast reconstruction. Much of the literature on breast augmentation and breast cancer has focused on cancer detection, prognosis, and recurrence. There is a paucity of data describing this patient population from a breast reconstruction standpoint. A review of a prospective institutional database of all patients who had previous breast augmentation undergoing immediate breast reconstruction (IBR) from 1996 to 2010 was performed. Patient demographics, operative techniques, reconstructive methods, and breast cancer data were collected. Data were compared with a control group of 591 patients without previous augmentation undergoing IBR from 2005 to 2009. Thirty-five patients treated by total mastectomy and IBR who had previous breast augmentation were identified. The median patient age was 51 (range, 32-80) years in the augmented group versus 50.1 (range, 24-84) years in the control group. The mean body mass indices of the augmented and the control groups were 24.1 and 27.5, respectively (P < 0.05). Implant-based reconstruction was performed in 94.3% the augmented group versus 62.4% in the control group (P < 0.01). Stage 0 and I breast cancer occurred in 57.6% of patients in the augmented group and 46.6% of patients in control group (P < 0.05). Patients with previous augmentation mammoplasty are more likely to undergo implant-based reconstruction compared with nonaugmented women. The presence of implants does not delay the detection of breast cancer when compared with a control group of patients who do not have breast implants.