Highlights
- •Prophylactic mastectomy can be performed in patients with unilateral. breast cancer without compromise of oncological treatment.
- •Obesity and active smoking are predictors for mastectomy complications.
- •Detailed discussions between surgeons and patients for the decision of undergoing CPM is imperative.
Abstract
Background
This study compared post-operative reconstructive complications and oncologic treatment
between patients who underwent unilateral versus bilateral nipple sparing mastectomy
(NSM) with implant based reconstruction (IBR).
Methods
Patients diagnosed with unilateral breast cancer who underwent NSM with IBR between
2010 and 2019 were reviewed. Patient demographics, surgical details, adjuvant therapy
and postoperative complications were analyzed.
Results
A total of 434 NSM with IBR were performed in 269 patients, 24% unilateral, and 76%
bilateral. The bilateral group received a direct implant significantly more frequently
and were younger compared to unilateral (p < 0.001). The unilateral group received post-mastectomy radiation therapy at significantly
higher rate (p < 0.001) with no difference in receipt of adjuvant chemotherapy.
Overall, 11% of mastectomies developed a 30-day complication requiring reoperation
and that extended to 13% at 120 days. There was no difference regarding the incidence
of complications requiring reoperation (p = 0.84) or complications type between the two groups (p = 0.29).
Conclusion
These findings support the oncologic and reconstructive equivalence to support patient
choice in CPM.
Keywords
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References
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Article info
Publication history
Published online: December 06, 2022
Accepted:
December 6,
2022
Received in revised form:
December 1,
2022
Received:
July 8,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
