Post-mastectomy Breast Reconstruction: Experience From the National Cancer Institute of Panama

Introduction Breast cancer is the most prevalent cancer among women worldwide and in Panama, where it represents a significant public health concern. Advances in early diagnosis and treatment have improved survival rates, shifting attention toward post-treatment quality of life. Mastectomy, while essential for curative treatment, often leads to physical and psychological challenges. Breast reconstruction has emerged as a key strategy to address these effects, with techniques varying between implant-based and autologous approaches, and timing options including immediate or delayed reconstruction. Despite its benefits, access to reconstruction remains limited in many countries. At the National Cancer Institute (NCI) of Panama, which serves the majority of breast cancer patients nationwide, there is limited documentation of post-mastectomy reconstruction practices. This study aims to describe the experience of breast reconstruction following total mastectomy at NCI between 2015 and 2019, providing insights into institutional practices and contributing to future strategies for equitable post-mastectomy care. Materials and methods A descriptive, observational, and retrospective study was conducted at the National Cancer Institute (NCI) of Panama. The study included female patients over 18 years of age who were diagnosed with breast cancer and underwent total mastectomy followed by immediate or delayed breast reconstruction between 2015 and 2019. Surgical techniques evaluated included implant-based reconstruction, latissimus dorsi flap with or without implant, and transverse rectus abdominis myocutaneous (TRAM) flap. Patients who underwent oncoplastic procedures after breast-conserving surgery were excluded. Data collected encompassed sociodemographic, clinical, and surgical variables, as well as comorbidities and postoperative complications. Data were extracted from electronic medical records and analyzed using Epi Info 7.2.5.  Results A total of 185 breast reconstructions were recorded, representing 13% of the total mastectomies performed. The mean age was 48 ± 9 years. According to the timing of reconstruction, 72% were delayed and 28% immediate. The mean time between mastectomy and delayed reconstruction was 3.2 years. The main reconstruction technique was tissue expander/prosthesis placement (55%) followed by latissimus dorsi flap reconstruction (26%). Early and late complications were observed in 22.7% and 17.3% of cases, respectively, with cellulitis being the most frequent complication in both periods. Conclusions At the NCI of Panama, an average of 37 breast reconstructions are performed annually in patients who have undergone total mastectomy. Most of these procedures are delayed using implant or tissue expander, with an average interval of 3.2 years between mastectomy and reconstruction.