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Analysis of Secondary Surgeries after Immediate Breast Reconstruction for Cancer Compared with Risk Reduction.
Stacey J Jones1, Philip Turton1, Rajgopal Achuthan1
1Department of Oncoplastic Breast and Reconstructive Surgery, St. James's University Hospital, Leeds, United Kingdom.
Plastic and Reconstructive Surgery. Global Open
|January 11, 2021
Summary
Cancer patients undergoing immediate breast reconstruction (IBR) are more likely to need planned secondary surgeries. Complications significantly increase unplanned secondary surgery rates in cancer patients, but not in risk reduction (RR) patients.
Area of Science:
- Plastic Surgery
- Oncology
- Breast Surgery
Background:
- Immediate breast reconstruction (IBR) is a common procedure for both cancer patients and those undergoing risk reduction (RR) mastectomy.
- Understanding secondary surgery patterns is crucial for optimizing patient outcomes and resource allocation in breast reconstruction.
Purpose of the Study:
- To compare the patterns and indications for secondary surgery in patients undergoing immediate breast reconstruction for cancer versus risk reduction.
- To identify factors influencing the need for unplanned secondary procedures following IBR.
Main Methods:
- A retrospective review of 299 patients who underwent mastectomy and IBR between 2013 and 2016 at a teaching hospital breast unit.
- Data included patient demographics, reason for IBR (cancer vs. RR), type of reconstruction, and all subsequent surgical procedures.
Main Results:
- Cancer patients (76%) were more likely than RR patients (24%) to undergo secondary surgery (68.4% vs. 56.3%), primarily for planned contralateral symmetrization or autologous conversion.
- While overall complication and reconstruction loss rates were similar, complications led to significantly higher unplanned secondary surgery rates in cancer patients (82.5% vs. 38.8%).
- Risk reduction patients had a higher rate of unplanned secondary surgery (48.7%) compared to planned (51.3%), potentially driven by aesthetic goals.
Conclusions:
- Secondary surgeries for immediate breast reconstruction differ significantly between cancer and risk reduction patients, with cancer patients more often requiring planned procedures.
- Complications are a major driver of unplanned secondary surgeries in cancer patients, necessitating careful management.
- A notable proportion of risk reduction patients undergo unplanned secondary surgery, suggesting a strong emphasis on achieving optimal aesthetic results.
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