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Early Postoperative Complication Rates in Women with Large Breasts (600+ grams) Undergoing Skin-Sparing and Nipple-Sparing Mastectomy with Immediate Reconstruction
Elizabeth A. Moroni, MD MHA, Casey Zhang, BS, Adam L. Johnson, MD, Suzanne Coopey, MD, Vaishali Purohit, MD, Tara Lamb, MD, Jasmine Dwyer, MD, Jenna Li, Emil J. Fernando, MD, Janette Gomez, DO, Jennifer Saldanha, MD, Thomas B. Julian, MD, Andrea Moreira, MD
University of Pittsburgh Medical Center
2024-02-01
Presenter: Elizabeth Moroni
Affidavit:
I certify the work on this present represents the original work of the resident.
Director Name: Vu Nguyen
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background
There is a paucity of data on complication rates of women with large-volume breasts (≥ 600g) undergoing Skin-Sparing Mastectomy (SSM) and Nipple-Sparing Mastectomy (NSM) with immediate breast reconstruction. This study aims to compare complication rates in patients with large-volume breasts after SSM versus NSM.
Methods
We identified patients at our institution who underwent SSM or NSM with immediate reconstruction from January 2020-June 2022. Demographics, treatments, and complication rates were compared between groups. Student's t-tests and chi-squared or Fisher's Exact tests were utilized to analyze continuous and categorical variables.
Results
In our cohort of 143 patients with breast resection weight ≥ 600g, a total of 100 patients underwent SSM and 43 patients underwent NSM followed by immediate breast reconstruction. Patients who underwent SSM had larger mean breast weights than their counterparts who underwent NSM (1015.57 vs 879.22g, p=0.0047). SSM patients had smaller implants placed compared to NSM patients (545cc vs 609cc, p=0.0038). Major complications occurred in 23.0% of SSM patients compared to 25.5% of NSM patients (p=0.067). Minor complications occurred in 32.0% of SSM versus 14.0% of NSM patients (p=0.042). SSM patients experienced more skin flap necrosis (15.00% vs 6.98%) and wound infections (11.00% vs 4.65%). Two out of 43 patients in the NSM group developed nipple necrosis.
Conclusions
We found no significant difference in complication rates between NSM and SSM with immediate reconstruction in patients with large-volume breasts (≥ 600g). Our findings suggest that NSM with immediate reconstruction is of equivalent safety to SSM in this patient population.
