The significance of timing in breast reconstruction after mastectomy

• Verfasst von: Knoedler, Samuel [VerfasserIn]
• Verfasst von: Kauke-Navarro, Martin [VerfasserIn]
• Verfasst von: Knödler, Leonard [VerfasserIn]
• Verfasst von: Friedrich, Sarah [VerfasserIn]
• Verfasst von: Ayyala, Haripriya S. [VerfasserIn]
• Verfasst von: Haug, Valentin [VerfasserIn]
• Verfasst von: Didzun, Oliver [VerfasserIn]
• Verfasst von: Hundeshagen, Gabriel [VerfasserIn]
• Verfasst von: Bigdeli, Amir Khosrow [VerfasserIn]
• Verfasst von: Kneser, Ulrich [VerfasserIn]
• Verfasst von: Machens, Hans-Guenther [VerfasserIn]
• Verfasst von: Pomahac, Bohdan [VerfasserIn]
• Verfasst von: Orgill, Dennis P. [VerfasserIn]
• Verfasst von: Broer, P. Niclas [VerfasserIn]
• Verfasst von: Panayi, Adriana C. [VerfasserIn]
• Titel: The significance of timing in breast reconstruction after mastectomy
• Titelzusatz: an ACS-NSQIP analysis
• Verf.angabe: Samuel Knoedler, Martin Kauke-Navarro, Leonard Knoedler, Sarah Friedrich, Haripriya S. Ayyala, Valentin Haug, Oliver Didzun, Gabriel Hundeshagen, Amir Bigdeli, Ulrich Kneser, Hans-Guenther Machens, Bohdan Pomahac, Dennis P. Orgill, P. Niclas Broer, Adriana C. Panayi
• E-Jahr: 2024
• Jahr: February 2024
• Umfang: 11 S.
• Illustrationen: Illustrationen
• Fussnoten: Online verfügbar: 1. Dezember 2023, Artikelversion: 21. Dezember 2023 ; Gesehen am 18.03.2024
• Titel Quelle: Enthalten in: Journal of plastic, reconstructive & aesthetic surgery
• Ort Quelle: Amsterdam [u.a.] : Elsevier, 2006
• Jahr Quelle: 2024
• Band/Heft Quelle: 89(2024) vom: Feb., Seite 40-50
• ISSN Quelle: 1878-0539
• DOI: doi:10.1016/j.bjps.2023.11.049
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Autologous breast reconstruction
• Sach-SW: Big data
• Sach-SW: Breast cancer
• Sach-SW: Delayed breast reconstruction
• Sach-SW: Immediate breast reconstruction
• Sach-SW: Implant-based breast reconstruction
• K10plus-PPN: 1883693837

Abstract

Background - A variety of breast reconstruction (BR) options are available. The significance of timing on outcomes remains debated. This study aims to compare complications in breast cancer patients undergoing implant-based and autologous BR immediately after mastectomy or at a delayed time point. - Methods - We reviewed the ACS-NSQIP database (2008-2021) to identify all female patients who underwent BR for oncological purposes. Outcomes were stratified by technique (implant-based versus autologous) and timing (immediate versus delayed), and included 30-day mortality, reoperation, (unplanned) readmission, and surgical and medical complications. - Results - A total of 21,560 patients were included: 11,237 (52%) implant-based (9791/87% immediate, 1446/13% delayed) and 10,323 (48%) autologous (8378/81% immediate, 1945/19% delayed). Complications occurred in 3666 (17%) patients (implant-based: n = 1112/11% immediate, n = 64/4.4% delayed cohorts; Autologous: n = 2073/25% immediate, n = 417/21% delayed cohorts). In propensity score weighting (PSW) analyses, immediate BR was associated with significantly more complications than delayed BR (p < 0.0001). This was the case for both implant-based and autologous BR, with a greater difference between the two time points noted in implant-based. Confounder-adjusted multivariable analyses confirmed these results. - Conclusion - At the 30-day time point, delayed BR is associated with significantly lower complication rates than immediate BR, in both the implant-based and autologous cohorts. These findings are not a blanket recommendation in favor of immediate and/or delayed BR. Instead, our insights may guide surgeons and patients in decision-making and help refine patients’ eligibility in a case-by-case workup.