Comparison of Immediate Breast Reconstruction Outcomes in Patients With and Without Prior Cosmetic Breast Surgery

Skin-sparing (SSM) and nipple-sparing mastectomy (NSM) with immediate breast reconstruction (IBR) have significantly increased. There is limited information on complications of IBR in patients with prior cosmetic breast surgery (CBS). We compare IBR outcomes in patients undergoing SSM and/or NSM wit...

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Published in:Clinical breast cancer 2022-02, Vol.22 (2), p.136-142
Main Authors: Fiser, Caroline K., Kronenfeld, Joshua P., Liu, Sophia N., Goel, Neha, Kassira, Wrood, Oeltjen, John C., Kesmodel, Susan B.
Format: Article
Language:English
Subjects:
Adult
Aged, 80 and over
Breast Neoplasms - psychology
Breast Neoplasms - surgery
Breast reconstruction complications
Breast reconstruction loss
Cosmetic breast surgery
Female
Humans
Immediate breast reconstruction
Mammaplasty - methods
Mammaplasty - psychology
Mastectomy, Subcutaneous - methods
Mastectomy, Subcutaneous - psychology
Middle Aged
Nipples - surgery
Organ Sparing Treatments - methods
Organ Sparing Treatments - psychology
Patient Satisfaction
Retrospective Studies
Skin and nipple-sparing mastectomy
Young Adult
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Summary:Skin-sparing (SSM) and nipple-sparing mastectomy (NSM) with immediate breast reconstruction (IBR) have significantly increased. There is limited information on complications of IBR in patients with prior cosmetic breast surgery (CBS). We compare IBR outcomes in patients undergoing SSM and/or NSM with and without prior CBS. Patients undergoing mastectomy from January 1, 2017 to December 31, 2019 were selected. Patient characteristics, surgical approach, and complications were compared between mastectomy and IBR cases for breasts with and without prior CBS. Binary logistic regression analysis was performed to identify predictors of complications and reconstruction loss. 956 mastectomies were performed in 697 patients, with IBR performed for 545 mastectomies in 356 patients. Median age was 51 (range 19-83), 45.8% of patients were age < 50, 62.6% of mastectomies were performed for breast cancer. 95 mastectomies (17.4%) were performed in breasts with prior CBS and 450 (82.6%) without. NSM was more frequently utilized for breasts with prior CBS (P < .001). Complications occurred in 80 mastectomies (14.7%); reconstruction loss in 30 (5.5%). On multivariable analysis, age ≥ 50 (OR 1.76, 95%CI 1.01-3.09, P = .047) and NSM (OR 2.11, 95%CI 1.17-3.79, P = .013) were associated with an increased risk of any complication. Prior CBS was not associated with an increased risk of complications (OR 1.11, 95%CI 0.58-2.14, P = .743) or reconstruction loss (OR 1.32, 95%CI 0.51-3.38, P = .567). In this analysis of mastectomy and IBR, prior CBS was not associated with an increased risk of complications or reconstruction loss. In patients with prior CBS undergoing mastectomy, IBR may be safely performed. In patients undergoing skin-sparing or nipple-sparing mastectomy with immediate breast reconstruction, prior cosmetic breast surgery did not increase risk of surgical complications or reconstruction loss. Mastectomy and immediate breast reconstruction can be safety performed in appropriately selected patients who have had prior cosmetic breast surgery.
ISSN:1526-8209
1938-0666
DOI:10.1016/j.clbc.2021.07.016