<< Back to the abstract archive
Utility and cost effectiveness of routine, histologic evaluation of the mastectomy scar in two-stage, implant-based reconstruction during expander-to-implant exchange
Jordan E. Fishman, MD, MPH
John H.Y. Pang, MD
Carolyn De La Cruz, MD
UPMC Plastic Surgery
2018-02-13
Presenter: Jordan E. FIshman
Affidavit:
Certified
Director Name: Vu Nguyen
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background: Routine histologic analysis of the mastectomy scar is well studied in the delayed breast construction population; no data regarding its utility in the immediate, staged reconstruction cohort has been published.
Methods: A retrospective review of all of the senior author's (CDC) patients who underwent immediate, staged reconstruction was performed. The mastectomy scar was routinely analyzed at the time of expander-to-implant exchange. 647 breasts were identified. The mastectomy scar, time between expander and permanent implant, average age of patient, and mastectomy indication were calculated. A cost analysis was completed.
Results: All scar pathology was negative for in-scar recurrence. The majority, 353 breasts, underwent mastectomy for carcinoma, 94 for germline mutations, 15 for high risk lesions, 6 for high family risk, and 179 for contralateral symmetry/risk reduction. The average age at mastectomy/expander placement was 47.7 10.3 years, the average time frame between expander placement and implant exchange was 254 152 days. The total histologic charge per breast is $602.
Conclusion: A clinically silent in-scar recurrence is a rare, at best, occurrence. Routine histologic analysis of the mastectomy scar can be safely avoided in the immediate, staged, reconstruction cohort.
