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Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
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Current Trends in Breast Reconstruction following Bilateral Prophylactic Mastectomy
Vivian J Hu1, Sean P McCleary1, Carolyn P Smullin1
1Division of Plastic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, Calif.
Plastic and Reconstructive Surgery. Global Open
|April 22, 2022
Summary
Implant-based reconstruction is most common after bilateral prophylactic mastectomy (BPM) for high-risk patients. Patient demographics like age and BMI influence reconstruction choices, with autologous reconstruction or mastectomy alone linked to specific patient profiles and outcomes.
Area of Science:
- Oncology
- Plastic Surgery
- Genetics
Background:
- Genetic susceptibility to breast cancer often leads to bilateral prophylactic mastectomy (BPM).
- Breast reconstruction is a common follow-up procedure after BPM.
- Understanding reconstructive trends is crucial for patient care.
Purpose of the Study:
- To characterize immediate breast reconstruction trends following BPM in genetically susceptible individuals.
- To identify factors influencing the choice of reconstruction technique.
- To analyze operative outcomes associated with different reconstruction methods.
Main Methods:
- Utilized the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database from 2010-2019.
- Examined demographic differences and operative outcomes based on reconstruction technique after BPM.
- Identified predictors for reconstruction type selection.
Main Results:
- Implant-based reconstruction (IBR) was the most frequent (71.8%) method.
- IBR patients were younger, more likely White, and had lower BMI (<25).
- Autologous reconstruction (AR) and mastectomy only (MO) cohorts had distinct demographic profiles and higher complication rates; age, BMI, and smoking predicted MO or AR over IBR.
Conclusions:
- This study is the first large-scale analysis of reconstruction trends in genetically susceptible patients undergoing BPM.
- Demographics significantly correlate with reconstruction choices and outcomes.
- Findings offer valuable insights for shared decision-making between surgeons and patients regarding breast reconstruction.
