OP2: Breast Reconstruction with a DIEP Flap in Elderly (>60 Years) Patients

Abstract

INTRODUCTION: Breast cancer is primarily a diagnosis of older women. Many patients seeking breast reconstruction are elderly women, aged over 60 years. Free tissue transfer carries the risk of perioperative morbidity and mortality in elderly patients. To clarify this issue we performed a comparative study. MATERIALS AND METHODS: A retrospective cohort study composed of chart review of all deep inferior epigastric perforator flap breast reconstruction patients at a single institution divided into an elderly cohort (60 years or older) and a non-elderly cohort (younger than 60 years). Demographic and comorbidity data were secondary predictor variables. Primary outcomes were complete flap loss, partial flap loss, or need for flap re-exploration. Secondary outcomes included surgical site occurrence, such as wound healing problems, seroma, and others. RESULTS: There were 173 flaps in the nonelderly cohort and 37 flaps in the elderly cohort. The elderly cohort had higher rates of diabetes, hypertension, and hyperlipidemia. Chi-square analysis showed no significant differences in primary outcomes between the two cohorts (1.1% vs 2.7%, p=0.459). Breast wound dehiscence was slightly higher in the elderly cohort (7.4% vs 5.4%, p=0.663). On logistic regression, being elderly was seen not as a significant risk factor for complete flap loss. The overall success rate for the nonelderly cohort was 97.3 percent, whereas the success rate for the nonelderly cohort was 98.7 percent. CONCLUSION: Elderly women desire breast reconstruction. Free flap breast reconstruction is a viable and safe procedure in these patients.