PROSPECTIVE EVALUATION OF IMMEDIATE RECONSTRUCTION AFTER MASTECTOMY

Objective The authors prospectively studied the impact of immediate br east reconstruction on patients undergoing mastectomy. Summary Backgro und Data Despite the advocation of a breast-conserving approach to the treatment of breast cancer, many women continue to medically require or choose mastectomy for the treatment of breast cancer. In recent yea rs, immediate breast reconstruction has become an alternative to eithe r mastectomy alone or to delayed reconstruction. Methods A prospective database of 216 patients who underwent mastectomy with immediate reco nstruction was established. In this series, 94 procedures involved imp lants or tissue expanders, and 124 tissue transfers were performed. Re sults The overall complication rate was 15.3%; only 9% of patients who underwent autologous tissue transfers required secondary procedures. When implants were performed, the overall rate of prosthetic loss was 8%. The majority of patients (n = 101) underwent transverse rectus abd ominis musculocutaneous (TRAM) flaps. Twenty-six of the 38 (17.5%) pat ients who required transfusion were from this group. Partial flap loss es in this group (7%) were correlated to a history of heavy smoking. W ith a median follow-up of 33.2 months, only two patients had recurred locally. According to patient opinion, autologous tissue transfers res ulted in a statistically better cosmetic result. Conclusions Immediate reconstruction can be performed safely and with excellent cosmetic re sults.