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Immediate-Delayed Breast Reconstruction: a valuable option in a selected group of patients undergoing mastectomy for breast cancer
Andrea Moreira Gonzalez,MD
Jose Roberto Ramirez,MD
Jamie Schwartz,MD
Steven Bernard,MD
Robert Lohman,MD
Risal Djohan,MD
Clevelan Clinic
2010-04-05
Presenter: Andrea Moreira
Affidavit:
Director Name:
Author Category: Resident/Fellow
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background: Immediate-delayed breast reconstruction is a technique used when postmastectomy radiation therapy is unknown.
Objective: To analyzed the outcome with immediate-delayed breast reconstruction.
Method: Retrospective review of patients with breast cancer T1 with unknown extension of the disease and T2 who underwent mastectomies with uncertain need for postoperative radiation therapy. The technique consisted in two-stage approach. In the first stage, mastectomy is performed and saline-filled tissue expander is placed to preserve the dimensions of the skin envelope; the expander is left in place until the final pathology results are available. In patients who do not require postmastectomy radiation therapy, stage 2 (definitive breast reconstruction) is performed within 2 weeks after mastectomy. In patients who require postmastectomy radiation, the tissue expander is left in place to permit skin-preserving delayed reconstruction after completion of radiotherapy. Data regarding patient's profile, tumor staging, radiation and chemotherapy, timing of surgery, complications and follow-up were recorded and analyzed by descriptive statistics.
Results: 40 patients underwent immediate-delayed breast reconstruction between 2008-2010. 32% patients proceed with autologous tissue flaps and 67% opted for permanent prosthesis. Overall complication rate was about 20%, mastectomy skin wound healing complication being the most common. Most patients were satisfied with the results.
Conclusion: Immediated-delayed breast reconstruction is a valid and useful method for certain subset of patients, particularly when radiation therapy is undecided or in patients that are unable to decide type of reconstruction or to take time off after surgery.
