P48. A NOVEL APPROACH TO PREDICTING RISK OF NECROSIS USING CLINICAL BREAST MEASUREMENTS

Abstract

PURPOSE: Skin flap necrosis after mastectomy is a common complication that increases the risk for infection and reconstructive failure. The aim of this study is to identify patients at increased risk of skin flap necrosis using pre-operative breast measurements. METHODS: A retrospective chart review of all patients undergoing immediate breast reconstruction by two surgeons between 2011 and 2021 was performed. Data was collected regarding pre-operative breast measurements such as nipple-notch (NN) distance, nipple-inframammary fold (NF) distance, chest width (CW), breast circumference (BC), and breast height (BH). These characteristics were used to estimate surface area of the breast and incidence of mastectomy skin flap necrosis was recorded. RESULTS: Over a ten-year-period, 536 women were included for a total of 902 breasts. The average age of our cohort was 50 ± 11 and average BMI was 25.9 ± 5.5. When surface area was approximated using either a cone without a base or a half ellipsoid, larger surface area was a significant risk factor for skin necrosis (p=0.027, 0.022, respectively). Larger measurements for NN, NF, CW, BC, and BH were also significant predictors of necrosis (p<0.05). CONCLUSION: Pre-operative breast measurements can be a useful adjunct for predicting skin flap necrosis in post-mastectomy patients. Patients with higher NN, NF, CW, BC, and BH measurements should be counseled that they are at higher risk of skin compromise following mastectomy.