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Establishing a Competing Risk Regression Nomogram Model for Survival Data
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Risk Factor Analysis for Survival of Becker-Type Expander in Immediate Breast Reconstruction
Sukru Yazar1, E Cigdem Karadag2, Altug Altinkaya1
1Plastic, Reconstructive and Aesthetic Surgery, School of Medicine, Acibadem Maslak Hospital, Acibadem University, Istanbul, Turkey.
Aesthetic Plastic Surgery
|March 11, 2018
Summary
Smoking and neoadjuvant therapy are key risk factors for Becker-type expander survival in immediate breast reconstruction. Lower expander fill volumes were linked to capsular contracture, a common complication.
Area of Science:
- Plastic Surgery
- Oncology
- Surgical Outcomes
Background:
- Immediate breast reconstruction using Becker-type expanders is a prevalent post-mastectomy procedure.
- Literature presents conflicting data on risk factors influencing Becker-type expander survival.
- This study aims to identify risk factors for expander survival and analyze complications associated with its removal.
Purpose of the Study:
- To investigate potential risk factors for Becker-type expander survival.
- To evaluate complications related to expander removal after immediate breast reconstruction.
- To identify predictors for adverse outcomes in breast reconstruction patients.
Main Methods:
- Retrospective chart review of patients undergoing mastectomy and immediate breast reconstruction with a Becker-type expander (November 2010 - November 2016).
- Analysis of electronic medical records for demographic, clinical, operative characteristics, and outcomes.
- Univariate Cox regression analysis to determine risk factors for expander survival.
Main Results:
- Capsular contracture (33.8%) was the most frequent complication, followed by skin flap necrosis (8.1%).
- Lower mean intraoperative expander fill volume and total volume were associated with capsular contracture.
- Smoking and neoadjuvant therapy were significantly linked to increased risk of expander removal (p=0.023 and p=0.006, respectively).
Conclusions:
- Expander volume and intraoperative fill volume may predict capsular contracture.
- Unlike some reports, radiotherapy showed no significant association with capsular contracture or expander survival.
- Smoking and neoadjuvant therapy are identified as primary risk factors for Becker-type expander survival in immediate breast reconstruction.
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