COMPARISON OF POSTOPERATIVE WOUND COMPLICATIONS AND EARLY CANCER RECURRENCE BETWEEN PATIENTS UNDERGOING MASTECTOMY WITH OR WITHOUT IMMEDIATE BREAST RECONSTRUCTION

The incidence of postoperative wound complications and early cancer re currence was studied in 289 patients who had mastectomy alone and in 1 13 patients who underwent immediate reconstruction following mastectom y. Patients undergoing immediate reconstruction were younger and had l ess advanced disease than patients who had mastectomy alone. The posto perative hospital stay was 3.8 days and 4.4 days (p <0.05) in patients with and without reconstruction, respectively. The overall incidence of postoperative complications was similar in the two groups of patien ts: 3 1% and 28% in patients with and without reconstruction, respecti vely. The incidence of postoperative seroma was higher among patients with mastectomy alone (19% versus 3%, p <0.05), whereas the incidence of other wound complications was similar in the two groups of patients . Prosthesis-specific complications occurred in 17%. Eight prostheses were removed because of complications. During the relatively short fol low-up period (approximately 20 months), local recurrence was noted in 16 patients (6%) who had mastectomy alone and in 1 patient (1%) who h ad immediate reconstruction after mastectomy (p <0.05). There was no s ignificant difference in the incidence of distant metastases between t he two groups of patients. The results suggest that immediate breast r econstruction can be performed following mastectomy for cancer without increased risk for overall postoperative complications, prolonged hos pital stay, or local recurrence. However, patients who choose to have immediate reconstruction need to be informed about risks for specific complications associated with the procedure, especially if an implant is used.