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Breast reconstruction is a viable option for older patients

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Abstract

Purpose

Breast cancer is diagnosed at a median age of 62 years in the USA. At the same time, mortality rates for breast cancer continue to decrease, falling by 40% from 1989 to 2016. In the coming decades, the number of elderly patients with breast cancer, potentially seeking reconstruction, is expected to increase.

Methods

A retrospective chart review of 309 patients, aged 60 years or older, undergoing immediate or delayed breast reconstruction, was conducted. Patient characteristics, clinical information and major complications requiring reoperation were evaluated. Multivariate analyses identified factors contributing to complications such as BMI, comorbidities, smoking status, history of previous breast conservation therapy (BCT), total expander volume, radiotherapy, and chemotherapy.

Results

26.7% of patients had at least one complication requiring reoperation, and 6.9% of patients suffered reconstructive failure. Logistic regression analysis of all patients (n = 309) found a statistically significant relationship between major complication and history of ipsilateral BCT (p = 0.026) and adjuvant chemotherapy (p = 0.005). Logistic regression analysis in patients undergoing tissue expander (TE) reconstruction (n = 215) showed that major complications were related to BMI over 35 kg/m2 (p = 0.04), history of ipsilateral BCT (p = 0.048), and adjuvant chemotherapy (p = 0.033).

Conclusion

Breast reconstruction in women over 60 years old was not independently associated with higher major complication rates in our series.

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Authors and Affiliations

  1. Division of Plastic and Reconstructive Surgery, Washington University in St Louis, St. Louis, MO, USA

    Utku C. Dolen, Jody Law, Marissa M. Tenenbaum & Terence M. Myckatyn

  2. West County Plastic Surgeons, Washington University School of Medicine, 1020 N. Mason Rd, Ste 110, Saint Louis, MO, 63141, USA

    Terence M. Myckatyn

Authors
  1. Utku C. Dolen
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  2. Jody Law
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  3. Marissa M. Tenenbaum
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  4. Terence M. Myckatyn
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Corresponding author

Correspondence to Terence M. Myckatyn.

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Conflict of interest

Marissa M. Tenenbaum has received speaker honoraria and advisory board fees from Allergan, Inc., in the last 2 years. She has received advisory board fees from RTI in the last year. Terence M. Myckatyn has received speaker honoraria and advisory board fees from Allergan, inc. in the last 2 years. Dr. Myckatyn has also received advisory board fees from RTI in the last year and also has an active investigator initiated research grant from RTI which is not related to this work. He receives lab funding from Sientra for completely unrelated work. Dr. Myckatyn is also a Co-Investigator on an award from the National Institutes of Health, Agency for Health Care Research and Quality (AHRQ), R18HS026699-01 “Implementing a breast reconstruction decision support tool in diverse practice settings.” This grant is also under the general umbrella of breast reconstruction research but not directly related to topic matter herein. The remaining authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional committee (the Human Research Protection Office (#201907106) at the Washington University School of Medicine) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study as regulated by the Human Research Protection Office (#201907106) at the Washington University School of Medicine.

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Dolen, U.C., Law, J., Tenenbaum, M.M. et al. Breast reconstruction is a viable option for older patients. Breast Cancer Res Treat 191, 77–86 (2022). https://doi.org/10.1007/s10549-021-06389-z

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  • DOI: https://doi.org/10.1007/s10549-021-06389-z

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