Post-mastectomy reconstruction: A risk-stratified comparative analysis of outcomes |
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Authors: | Sujata Saha Armando A. Davila Jon P. Ver Halen Umang K. Jain Nora Hansen Kevin Bethke Seema A. Khan Jacqueline Jeruss Neil Fine John Y.S. Kim |
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Affiliation: | 1. Division of Plastic and Reconstructive Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA;2. Department of Plastic Surgery, University of Tennessee, Health Science Center, Memphis, TN, USA;3. Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA |
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Abstract: | IntroductionAlthough breast reconstruction following mastectomy plays a role in the psychological impact of breast cancer, only one in three women undergo reconstruction. Few multi-institutional studies have compared complication profiles of reconstructive patients to non-reconstructive.MethodsUsing the National Surgical Quality Improvement database, all patients undergoing mastectomy from 2006 to 2010, with or without reconstruction, were identified and risk-stratified using propensity scored quintiles. The incidence of complications and comorbidities were compared.ResultsOf 37,723 mastectomies identified, 30% received immediate breast reconstruction. After quintile matching for comorbidities, complications rates between reconstructive and non-reconstructives were similar. This trend was echoed across all quintiles, except in the sub-group with highest comorbidities. Here, the reconstructive patients had significantly more complications than the non-reconstructive (22.8% versus 7.0%, p < 0.001).ConclusionImmediate breast reconstruction is a well-tolerated surgical procedure. However, in patients with high comorbidities, surgeons must carefully counterbalance surgical risks with psychosocial benefits to maximize patient outcomes.Level of evidenceLevel 3 |
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Keywords: | Breast reconstruction Implant Tissue expander Submuscular Complication Outcomes |
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