One Hundred Forty-One Consecutive Attempts at Autologous Tissue Single-Stage Breast Cancer Reconstruction

Abstract

The analysis of a single surgeon's 5 year attempt at performing autologous tissue breast cancer reconstruction, with one general anesthetic. A single-stage breast cancer reconstruction is successful if after the original reconstruction, no correction for complications, revision of breast mound, or contralateral breast procedures are performed, under general anesthetic, to complete the reconstruction. This is a review of a single surgeon's breast reconstruction practice. Three hundred fifty-six breast cancer reconstruction patients had surgery in a period of 5 years. One hundred forty-one of 356 (39.6%) were consecutive attempts at single-stage autologous tissue reconstruction: 106 of 141 (75.1%) were free abdominal flaps (transverse rectus abdominis myocutaneous, muscle-sparing flaps [MS], or deep inferior epigastric artery perforator flaps), 29 of 141 (20.6%) pedicled transverse rectus abdominis myocutaneous flaps, and 6 of 141 (4.3%) latissimus dorsi flaps; 37 of 141 (26.2%) were immediate reconstructions, 100 of 141 (70.9%) delayed reconstructions, and 4 of 141 (2.8%) mixed reconstructions. One hundred seven of the 141 patients (75.9%) had their autologous tissue reconstruction successfully performed in one general anesthetic. Reconstructions requiring more than one general anesthetic were due to 18 of 141 (12.8%) postoperative and donor-site complications, 16 of 141 (11.3%) revisions of breast mound or contralateral breast procedures. A total of 34 of 141 (24.1%) reconstructions required a second general anesthetic for successful completion, only 16 of 141 (11.3%) of autologous tissue breast cancer reconstructions required revisions for symmetry. Therefore, single-stage breast cancer reconstruction is feasible and should be attempted to decrease the morbidity of breast cancer survivors.