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Complications in immediate breast reconstruction after mastectomy

Published online by Cambridge University Press:  04 October 2011

Alberto Jiménez-Puente ,
Elisa Prieto-Lara ,
Antonio Rueda-Domínguez ,
Claudio Maañón-Di Leo ,
Nicolás Benítez-Parejo ,
Francisco Rivas-Ruiz ,
Francisco J. Medina-Cano  and
Emilio Perea-Milla
Alberto Jiménez-Puente
Affiliation:
Hospital Costa del Sol and CIBER Epidemiología y Salud Pública (CIBERESP)
Elisa Prieto-Lara
Affiliation:
Hospital Virgen de la Victoria
Antonio Rueda-Domínguez
Affiliation:
Hospital Costa del Sol
Claudio Maañón-Di Leo
Affiliation:
Hospital Costa del Sol
Nicolás Benítez-Parejo
Affiliation:
Hospital Costa del Sol and CIBER Epidemiología y Salud Pública (CIBERESP)
Francisco Rivas-Ruiz
Affiliation:
Hospital Costa del Sol and CIBER Epidemiología y Salud Pública (CIBERESP)
Francisco J. Medina-Cano
Affiliation:
Hospital Costa del Sol
Emilio Perea-Milla
Affiliation:
CIBER Epidemiología y Salud Pública (CIBERESP) and Hospital Costa del Sol
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Abstract

Objectives: Immediate post-mastectomy breast reconstruction (IBR) is a procedure that has proven advantages, but it also entails risks. The aim of this study was to identify risk factors for reconstruction failure.

Methods: A review was made of all the IBR carried out at a general hospital from 2002 to 2009. Retrospective information was obtained about postoperative complications and the characteristics of patients and treatments applied. The minimum follow-up period was 9 months. Cox's regression analysis was performed on the variables related to the reconstruction failure requiring the removal of the prosthesis, with an explanatory model in which all the study variables were introduced and a predictive model that contained only the variables known before the intervention.

Results: A total of 115 IRB interventions carried out on 112 women with breast cancer were analyzed. The mean follow-up period was 25.5 months. In sixty cases (52.2 percent), there were no complications; in sixteen cases (13.9 percent) minor complications appeared, and in 39 (33.9 percent) the complications were moderate. In twenty-six cases (22.6 percent), a reconstruction failure occurred. Cox's regression model revealed that the reconstruction failures were related to the patient's age (Hazard Ratio 1.08), to neoadjuvant chemotherapy (HR 6.24) and to postoperative tamoxifen (HR 3.10). The predictive model included the age of the patient (HR 1.05) and the use of neoadjuvant chemotherapy (HR 5.11).

Conclusions: A significant proportion of the patients receiving IBR developed reconstruction failure. Multivariate analysis identified three variables related to this complication, two of which were known before the intervention.

Keywords

Breast cancerImmediate breast reconstructionComplications
Type
ASSESSMENTS
Information
International Journal of Technology Assessment in Health Care , Volume 27 , Issue 4 , October 2011 , pp. 298 - 304
Copyright
Copyright © Cambridge University Press 2011

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References

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