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Complications following bilateral prophylactic mastectomy
Mary B Barton1, Carmen N West, In-Lu A Liu
1Department of Ambulatory Care and Prevention, Harvard Pilgrim Health Care, 133 Brookline Ave., 6th Floor, Boston, MA 02215, USA. mary_barton@hms.harvard.edu
Journal of the National Cancer Institute. Monographs
|November 17, 2005
Summary
Bilateral prophylactic mastectomy significantly reduces breast cancer risk. However, nearly two-thirds of women experience complications like pain, infection, or seroma, especially after reconstruction.
Area of Science:
- Oncology
- Surgical Outcomes
- Public Health
Background:
- Bilateral prophylactic mastectomy is a key strategy for reducing breast cancer risk.
- Previous complication data for this procedure is limited to single-site studies.
- This study examines complications in a multisite, community-based cohort.
Purpose of the Study:
- To determine the frequency and types of complications following bilateral prophylactic mastectomy.
- To compare complication rates based on reconstruction methods (implant vs. tissue graft) and timing.
- To provide data from a diverse, community-based population.
Main Methods:
- A cohort of 269 women aged 18-80 undergoing bilateral prophylactic mastectomy without prior breast cancer was identified.
- Data was collected from automated sources and detailed chart reviews.
- Complications and reconstructive procedures (implant or tissue graft) were tracked for one year post-surgery.
Main Results:
- 64% of women experienced at least one complication within a year.
- Common complications included pain (35%), infection (17%), and seroma (17%).
- Reconstruction, particularly with tissue grafts, was associated with higher complication rates compared to no reconstruction. Delayed reconstruction showed a trend towards increased complications.
Conclusions:
- Bilateral prophylactic mastectomy is associated with a high rate of complications, affecting nearly two-thirds of patients.
- Reconstruction type and timing significantly influence complication risk.
- Further research is needed to mitigate and understand these surgical complications.