MANAGEMENT, MORBIDITY, AND ONCOLOGIC ASPECTS IN 100 CONSECUTIVE PATIENTS WITH IMMEDIATE BREAST RECONSTRUCTION

Background: Immediate breast reconstruction (IBR) is indicated when br east-conserving surgery is inappropriate and the patient refuses maste ctomy as the sole procedure. Methods: Management, morbidity, and oncol ogic aspects were studied in 100 consecutive patients treated between 1990 and 1994 with a minimum follow-up time of 2 years. Indications fo r mastectomy and IBR always were discussed within a multidisciplinary group. Eighty-four patients had primary breast cancer, 12 patients und erwent salvage mastectomy for an ipsilateral breast tumor recurrence, two patients had benign breast disease, and two patients underwent pro phylactic mastectomy because of familial breast cancer. Results: Salin e and silicone gel-filled implants were used predominantly (88%), but free and pedicled TRAM flaps were performed in 12 patients (12%). The overall complication rate was 16%. Seven patients lost their implants, three of whom had been irradiated to the chest wall. Sixty-five patie nts completed breast reconstruction (nipple and areola) within a media n time of 418 days (range 40 to 1471 days). At follow-up, eight patien ts had locoregional recurrences after a median time of 7.2 months (ran ge 1 to 23 months), and nine patients had died from disseminated breas t cancer. Conclusion: IBR is time-consuming, but it is well tolerated and does not interfere with oncologic adjuvant treatment. IBR can be p erformed with low morbidity by a dedicated multidisciplinary team.