LymphedemaV1, Main, Exploration, bibRecord, 001255

Complications After Mastectomy and Immediate Breast Reconstruction for Breast Cancer: A Claims-Based Analysis

Identifieur interne : 001255 ( Main/Exploration ); précédent : 001254; suivant : 001256

Complications After Mastectomy and Immediate Breast Reconstruction for Breast Cancer: A Claims-Based Analysis

Auteurs : Reshma Jagsi ; Jing Jiang [États-Unis] ; Adeyiza O. Momoh [États-Unis] ; Amy Alderman [États-Unis] ; Sharon H. Giordano [États-Unis] ; Thomas A. Buchholz [États-Unis] ; Lori J. Pierce ; Steven J. Kronowitz [États-Unis] ; Benjamin D. Smith [États-Unis]

Source :

Annals of surgery [ 0003-4932 ] ; 2016.

RBID : PMC:4824182

Abstract

Objective

To evaluate complications after post-mastectomy breast reconstruction, particularly in the setting of adjuvant radiotherapy.

Summary-Background Data

Most studies of complications after breast reconstruction have been conducted at centers of excellence; relatively little is known about complication rates in radiated patients treated in the broader community. This information is relevant for breast cancer patients' decision-making.

Methods

Using the claims-based MarketScan database, we described complications in 14,894 women undergoing mastectomy for breast cancer from 1998-2007 who received immediate autologous reconstruction (n=2637), immediate implant-based reconstruction (n=3007), or no reconstruction within the first two postoperative years (n=9250). We used a generalized estimating equation to evaluate associations between complications and radiotherapy over time.

Results

Wound complications were diagnosed within the first two postoperative years in 2.3% of patients without reconstruction, 4.4% with implants, and 9.5% with autologous reconstruction (p<0.001). Infection was diagnosed within the first two postoperative years in 12.7% of patients without reconstruction, 20.5% with implants, and 20.7% with autologous reconstruction (p<0.001). 5219 (35%) women received radiation. Radiation was not associated with infection in any surgical group within the first six months but was associated with an increased risk of infection in months 7-24 in all three groups (each p<0.001). In months 7-24, radiation was associated with higher odds of implant removal in patients with implant reconstruction (OR 1.48, p<0.001) and fat necrosis in those with autologous reconstruction (OR=1.55; P=0.01).

Conclusions

Complication risks after immediate breast reconstruction differ by approach. Radiation therapy appears to modestly increase certain risks, including infection and implant removal.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4824182

DOI: 10.1097/SLA.0000000000001177
PubMed: 25876011
PubMed Central: 4824182

Affiliations:

Le document en format XML

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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title>
<p id="P1">To evaluate complications after post-mastectomy breast reconstruction, particularly in the setting of adjuvant radiotherapy.</p>
</sec>
<sec id="S2"><title>Summary-Background Data</title>
<p id="P2">Most studies of complications after breast reconstruction have been conducted at centers of excellence; relatively little is known about complication rates in radiated patients treated in the broader community. This information is relevant for breast cancer patients' decision-making.</p>
</sec>
<sec id="S3"><title>Methods</title>
<p id="P3">Using the claims-based MarketScan database, we described complications in 14,894 women undergoing mastectomy for breast cancer from 1998-2007 who received immediate autologous reconstruction (n=2637), immediate implant-based reconstruction (n=3007), or no reconstruction within the first two postoperative years (n=9250). We used a generalized estimating equation to evaluate associations between complications and radiotherapy over time.</p>
</sec>
<sec id="S4"><title>Results</title>
<p id="P4">Wound complications were diagnosed within the first two postoperative years in 2.3% of patients without reconstruction, 4.4% with implants, and 9.5% with autologous reconstruction (p<0.001). Infection was diagnosed within the first two postoperative years in 12.7% of patients without reconstruction, 20.5% with implants, and 20.7% with autologous reconstruction (p<0.001). 5219 (35%) women received radiation. Radiation was not associated with infection in any surgical group within the first six months but was associated with an increased risk of infection in months 7-24 in all three groups (each p<0.001). In months 7-24, radiation was associated with higher odds of implant removal in patients with implant reconstruction (OR 1.48, p<0.001) and fat necrosis in those with autologous reconstruction (OR=1.55; P=0.01).</p>
</sec>
<sec id="S5"><title>Conclusions</title>
<p id="P5">Complication risks after immediate breast reconstruction differ by approach. Radiation therapy appears to modestly increase certain risks, including infection and implant removal.</p>
</sec>
</div>
</front>
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<name sortKey="Pierce, Lori J" sort="Pierce, Lori J" uniqKey="Pierce L" first="Lori J." last="Pierce">Lori J. Pierce</name>
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<country name="États-Unis"><region name="Texas"><name sortKey="Jiang, Jing" sort="Jiang, Jing" uniqKey="Jiang J" first="Jing" last="Jiang">Jing Jiang</name>
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<name sortKey="Buchholz, Thomas A" sort="Buchholz, Thomas A" uniqKey="Buchholz T" first="Thomas A." last="Buchholz">Thomas A. Buchholz</name>
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Complications After Mastectomy and Immediate Breast Reconstruction for Breast Cancer: A Claims-Based Analysis

Complications After Mastectomy and Immediate Breast Reconstruction for Breast Cancer: A Claims-Based Analysis

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Abstract

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