Immediate Breast Reconstruction Recommended After Mastectomy

Immediate breast reconstruction for women undergoing mastectomy for breast cancer has a low risk of complications and does not cause undue delays in cancer treatment, according to a new study.

Researchers at the University of California, Los Angeles (UCLA; USA) conducted a study involving 170 patients over a 10-year period who were diagnosed with stage IIB or greater breast cancer, and whom were treated with mastectomy followed by immediate breast reconstruction. In all, 157 unilateral and 13 bilateral reconstructions were performed, predominantly by means of free transverse rectus abdominis musculocutaneous flaps. The average patient age was 47 years and the average hospital stay was 5.1 days; complication rates and reconstructive aesthetics were determined.

The results showed that there were 15 major complications (8.8%), but adjuvant postoperative therapy was delayed in only eight patients (4.7%), with the maximum delay lasting 3 weeks in one patient. Although some degree of flap shrinkage was noted in 30% of patients treated with postoperative radiotherapy, only 10% of patients experienced severe breast distortion. The overall cosmetic outcome in patients who underwent postoperative irradiation was comparable to that of those who did not. The study was published in July 2011 issue of Plastic and Reconstructive Surgery.

“Immediate breast reconstruction in the setting of advanced-stage breast cancer is safe and well tolerated by patients, and is not associated with significant delays in adjuvant therapy,” concluded lead author Christopher Crisera, MD, and colleagues of the division of plastic and reconstructive surgery. “The changes caused by radiation to the reconstructed breast appear to be less significant than previously reported, and readily addressed to complete an ultimate reconstruction that is aesthetically acceptable to both surgeon and patient.”

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