The American Journal of Surgery
Volume 198, Issue 5 , Pages 658-663, November 2009

Effective breast reconstruction in female veterans

  • Mimi Leong, M.D., M.S.

      Affiliations

    • Section of Plastic Surgery, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
    • Division of Plastic Surgery, Baylor College of Medicine, Houston, TX, USA
    • Corresponding Author InformationCorresponding author: Tel.: 713-794-7814; fax: 713-794-7352
  • ,
  • Chuma J. Chike-Obi, M.D.

      Affiliations

    • Division of Plastic Surgery, Baylor College of Medicine, Houston, TX, USA
  • ,
  • C. Bob Basu, M.D., M.P.H.

      Affiliations

    • Institute of Advanced Breast Reconstruction, Houston, TX, USA
  • ,
  • Edward I. Lee, M.D.

      Affiliations

    • Division of Plastic Surgery, Baylor College of Medicine, Houston, TX, USA
  • ,
  • Daniel Albo, M.D., Ph.D.

      Affiliations

    • Section of General Surgery, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
  • ,
  • David T. Netscher, M.D.

      Affiliations

    • Section of Plastic Surgery, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
    • Division of Plastic Surgery, Baylor College of Medicine, Houston, TX, USA

Received 6 May 2009; received in revised form 2 July 2009

Abstract 

Background

Despite increasing female veteran numbers, literature regarding reconstruction after breast cancer is lacking. The purpose of this study was to examine breast reconstruction referral rates and reconstruction outcomes at a tertiary Veterans Affairs hospital.

Methods

Female breast cancer patients (1997–2008) were identified. Demographics, tumor stage, oncologic therapies, reconstructive timings and procedures, and complications were noted.

Results

Eighty-two women underwent mastectomy (46%) or breast conservation (43%). The referral rates to plastic surgery were 61% (mastectomy) and 32% (overall). Reconstruction rates were 42% (mastectomy) and 22% (overall). Sixty-nine percent were suitable candidates and chose immediate (67%) or delayed (33%) reconstruction, with implant-based (44%), autologous (39%), or autologous plus implants (17%). There were complications (28%) but no mortalities. Comorbidities were not correlated with outcomes.

Conclusions

Breast reconstruction can be effectively delivered within the Veterans Affairs system. It is essential that sufficient Veterans Affairs resources be deployed to address the increasing reconstructive needs of female veterans.

Keywords: Breast reconstruction, Female veterans, Multidisciplinary teams

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PII: S0002-9610(09)00447-4

doi:10.1016/j.amjsurg.2009.07.020

The American Journal of Surgery
Volume 198, Issue 5 , Pages 658-663, November 2009