Is Immediate Breast Reconstruction an Option for Elderly Women? A Comparative Study Between Elderly and Younger...

To evaluate the incidence of postoperative complications (POC) in elderly patients (EP) compared to younger patients (YP) following immediate breast reconstruction (IBR) after total mastectomy (TM).

This retrospective study included patients treated at the Institut Universitaire of Cancer of Toulouse-Oncopole (IUCT-O) between January 2014 and May 2022. The primary outcome was the incidence of POC within 30 days postoperatively. Secondary outcomes included the delay before initiation of adjuvant treatments and re-hospitalization rates.

Elderly patients had a significantly higher rate of POC compared to younger patients, affecting 27.9% of EP and only 14.8% of YP. However, the severity of complications does not differ significantly between YP and EP (69.1% of major POC for YP and 64.7% for EP, P = .6680). Rates of re-hospitalization within 30 days between the 2 groups are similar (67.3% for YP and 61.8% for EP, P = .5962). Most importantly, these complications are not responsible for a delay in initiating adjuvant treatment compared with the younger population. Age ≥ 70 years and obesity (BMI ≥ 30) were identified as independent risk factors for POC.

Despite a higher rate of POC, immediate breast reconstruction can be considered for elderly patients, but these patients should be carefully selected and assessed preoperatively to limit the risk of POC.