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Short-term outcomes of immediate breast reconstruction using an implant or tissue expander after mastectomy in breast cancer patients

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Abstract

Background

Mastectomy is an optional surgical management of breast cancer, but it can cause significant adverse reactions. Breast reconstruction is a concern in post-mastectomy recovery. We assessed the oncologic safety and patient satisfaction following immediate breast reconstruction using an implant or tissue expander.

Methods

We retrospectively reviewed all patients who underwent reconstruction with an implant or tissue expander immediately after mastectomy. Seventy-seven patients underwent breast reconstruction at a general hospital breast cancer center from January 2008 to December 2010. Fourteen patients were excluded due to loss at follow-up, so 63 patients were included in this study. Questionnaires were sent to all patients to assess patient satisfaction.

Results

Mean age was 44.1 years (range 29–64). After a median follow-up period of 22.4 months, there was 1 case of locoregional recurrence, 1 case of distant metastasis, and an overall breast cancer-specific survival of 100 %. Overall rate of major complications, such as nipple areolar complex (NAC) necrosis and implant removal, was 11.1 % (7 patients). Of the 10 patients who had NAC necrosis, 6 patients improved after observation and 4 patients had NAC excision. Three patients had their implant removed due to severe infection, leakage, and dissatisfaction, respectively. There were 32 cases of total mastectomy (TM), 12 cases of skin-sparing mastectomy (SSM), and 19 cases of NAC-sparing mastectomy (NSM). According to the questionnaire, 84.1 % were satisfied with the general operational result and 77.8 % with the cosmetic result. Of the 31 patients who received conservative surgery, 87.1 % were satisfied with the general result and 83.9 % with the cosmetic result.

Conclusions

Immediate breast reconstruction using an implant after mastectomy was technically feasible and oncologically safe. In addition, the reconstruction resulted in a relatively high rate of patient satisfaction. Further long-term studies are warranted to confirm these findings.

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Notes

  1. The locoregional recurrence case was a 49-year-old woman who had undergone NSM for invasive ductal carcinoma developed ipsilateral axillary recurrence

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of General Surgery, Catholic Kwandong University College of Medicine, Cheil General Hospital, 1-19 Mukjeong-dong, Jung-gu, Seoul, 100-380, Korea

    Se Won Kim, Hae Kyung Lee, Sun Mi Kang, Tae Ho Kang, Chan Seok Yoon, Seung Sang Ko, Min Hee Hur & Sung Soo Kang

  2. JW Plastic Surgery, Seoul, Korea

    Chul Hwan Seul

  3. Department of Nursing, Graduate School of Kyung Hee University, Seoul, Korea

    Ja Sung Gu

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  1. Se Won Kim
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  2. Hae Kyung Lee
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Correspondence to Hae Kyung Lee.

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Kim, S.W., Lee, H.K., Kang, S.M. et al. Short-term outcomes of immediate breast reconstruction using an implant or tissue expander after mastectomy in breast cancer patients. Breast Cancer 23, 279–285 (2016). https://doi.org/10.1007/s12282-014-0570-y

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