Patient satisfaction and complication rate after mastectomy with immediate two-stage breast reconstruction as compared to mastectomy without immediate breast reconstruction

The objectives of this study were to evaluate 1) the rate of immediate breast reconstruction; 2) the frequency of immediate tissue expander placement; and 3) to compare perioperative outcomes in patients who underwent breast reconstruction after mastectomy for breast cancer with immediate tissue expander placement (TE) with those with no reconstruction (NR). Using the Nationwide Inpatient Sample database, we examined the clinical data of patients with breast cancer who underwent mastectomy with or without immediate TE from 2006 to 2010 in the United States. A total of 344,253 patients with breast cancer underwent mastectomy in this period in the United States. Of these patients, 31 per cent had immediate breast reconstruction. We only included patients with mastectomy and no reconstruction (NR: 237,825 patients) and patients who underwent only TE placement with no other reconstruction combination (TE: 61,178 patients) to this study. Patients in the TE group had a lower overall postoperative complication rate (2.6 vs 5.5%; P < 0.01) and lower in-hospital mortality rate (0.01 vs 0.09%; P < 0.01) compared with the NR group. Fifty-three per cent of patients in the NR group were discharged the day of surgery compared with 36 per cent of patients in the TE group. Using multivariate regression analyses and adjusting patient characteristics and comorbidities, patients in the TE group had a significantly lower overall complication rate (adjusted odds ratio [AOR], 0.6) and lower in-hospital mortality (AOR, 0.2) compared with the NR group. The rate of immediate reconstruction is 31 per cent. TE alone is the most common type of immediate reconstruction (57%). There is a lower complication rate for the patients who underwent immediate TE versus the no-reconstruction cohort.

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Oncological outcome and patient satisfaction with skin-sparing mastectomy and immediate breast reconstruction: a prospective observational study

BMC Cancer ◽

10.1186/1471-2407-10-171 ◽

2010 ◽

Vol 10 (1) ◽

Cited By ~ 38

Author(s):

Sara Reefy ◽

Neill Patani ◽

Anne Anderson ◽

Gwyne Burgoyne ◽

Hisham Osman ◽

...

Keyword(s):

Patient Satisfaction ◽

Observational Study ◽

Breast Reconstruction ◽

Prospective Observational Study ◽

Oncological Outcome ◽

Immediate Breast Reconstruction

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Quality of life and patient satisfaction in breast cancer patients after immediate breast reconstruction: a prospective study

The Breast ◽

10.1016/j.breast.2004.10.008 ◽

2005 ◽

Vol 14 (3) ◽

pp. 201-208 ◽

Cited By ~ 198

Author(s):

Elisabeth Edström Elder ◽

Yvonne Brandberg ◽

Tina Björklund ◽

Richard Rylander ◽

Jakob Lagergren ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Patient Satisfaction ◽

Breast Reconstruction ◽

Prospective Study ◽

Cancer Patients ◽

Immediate Breast Reconstruction ◽

Breast Cancer Patients ◽

A Prospective Study

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Skin Sparing Mastectomy with Preservation of Nipple Areola Complex and Immediate Breast Reconstruction in Patients with Breast Cancer: A Single Centre Prospective Study

Plastic Surgery International ◽

10.1155/2014/589068 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 5

Author(s):

Debarati Chattopadhyay ◽

Souradip Gupta ◽

Prabir Kumar Jash ◽

Marang Buru Murmu ◽

Sandipan Gupta

Keyword(s):

Breast Cancer ◽

Patient Satisfaction ◽

Local Recurrence ◽

Breast Reconstruction ◽

Frozen Section ◽

Immediate Breast Reconstruction ◽

Breast Cancer Patients ◽

Nipple Areola Complex ◽

Areola Complex ◽

The Aesthetic

Background. Skin and nipple areola sparing mastectomy (NASM) has recently gained popularity as the management of breast cancer. This study aims to evaluate the aesthetic outcome, patient satisfaction, and oncological safety of NASM. Methods. The study prospectively analyzes the results of NASM and immediate breast reconstruction in 34 women with breast cancer. The criteria for inclusion were core biopsy-proven, peripherally located breast cancer of any tumor size and with any “N” status, with documented negative intraoperative frozen section biopsy of retroareolar tissue, and distance from the nipple to tumor margin >2 cm on mammography. Results. The median age of the patients was 45 years. The majority had either stage II or stage III breast cancer. The median mammographic distance of tumor from nipple areola complex (NAC) was 3.8 cm. The overall operative morbidity was minimal. The NAC could be preserved in all the patients. There was no local recurrence of tumor at median follow-up of 28.5 months. The aesthetic outcomes were satisfactory. Conclusion. NASM and immediate breast reconstruction can be successfully achieved with minimal morbidity and very low risk of local recurrence in appropriately selected breast cancer patients, with acceptable aesthetic results and good patient satisfaction.

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Robotic Versus Conventional Nipple-Sparing Mastectomy With Immediate Breast Reconstruction

Frontiers in Oncology ◽

10.3389/fonc.2021.637049 ◽

2021 ◽

Vol 11 ◽

Author(s):

Gilles Houvenaeghel ◽

Julien Barrou ◽

Camille Jauffret ◽

Sandrine Rua ◽

Laura Sabiani ◽

...

Keyword(s):

Breast Reconstruction ◽

Complication Rate ◽

Immediate Breast Reconstruction ◽

Predictive Score ◽

Patient’S Satisfaction ◽

Duration Of Surgery ◽

Nipple Sparing Mastectomy ◽

Nipple Sparing ◽

Complications Rate ◽

Length Of Hospitalization

BackgroundSeveral studies reported the feasibility and safety of robotic-NSM (R-NSM). The aim of our prospective study was to compare R-NSM and conventional-NSM (C-NSM).MethodsWe analyzed patients who were operated on with and without robotic assistance (R-NSM or C-NSM) and who received immediate breast reconstruction (IBR) with implant or latissimus dorsi-flap (LDF). The main objective was complication rate and secondary aims were post-operative length of hospitalization (POLH), duration of surgery, and cost.ResultsWe analyzed 87 R-NSM and 142 C-NSM with implant-IBR in 50 and 135 patients, with LDF-IBR in 37 and 7 patients, respectively. Higher durations of surgery and costs were observed for R-NSM, without a difference in POLH and interval time to adjuvant therapy between R-NSM and C-NSM. In the multivariate analysis, R-NSM was not associated with a higher breast complication rate (OR=0.608) and significant factors were breast cup-size, LDF combined with implant-IBR, tobacco and inversed-T incision. Grade 2-3 breast complications rate were 13% for R-NSM and 17.3% for C-NSM, significantly higher for LDF combined with implant-IBR, areolar/radial incisions and BMI>=30. A predictive score was calculated (AUC=0.754). In logistic regression, patient’s satisfaction between C-NSM and R-NSM were not significantly different, with unfavorable results for BMI >=25 (OR=2.139), NSM for recurrence (OR=5.371) and primary breast cancer with radiotherapy (OR=4.533). A predictive score was calculated. In conclusion, our study confirms the comparable clinical outcome between C- NSM and R-NSM, in the price of longer surgery and higher cost for R-NSM. Predictive scores of breast complications and satisfaction were significantly associated with factors known in the pre-operative period.

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