Abstract P3-14-11: Risk factors affecting post-operative complication after immediate reconstruction with implant for operable breast cancer patients
Authors: Park SJ , Choi JH , Lee MH , Jung S-Y , Lee ES 
Published: March 2017

Purpose :

Immediate breast reconstruction (IBR) with implant after nipple-areola complex (NAC) sparing mastectomy is an increasing treatment for breast cancer patients. Old age, obesity, smoking history, large volume of implant and adjuvant oncologic therapies have been known as risk factors for post-operative complication after IBR. However, less is known about the risk factors after IBR with implant in Asian women with relatively low body mass index (BMI), small volume of breast and less history of smoking. We analyzed the risk factors for post-operative complications after IBR with implant in patients receiving NAC sparing mastectomy.

Methods :

We investigated a prospectively maintained database from 2012 to 2015 at National Cancer Center. A total of 278 breast reconstructions (230 unilateral, 24 bilateral) in 254 patients were performed by a single surgeon; 99.3% (276 of 278 breasts) were oncologic, and 0.7% (2 of 278 breasts) were prophylactic mastectomy. For each patient, we collected data on age, BMI, history of smoking and diabetes mellitus, volume of implant, adjuvant oncologic therapies, distances from tumor to nipple and skin, imprecise magnetic resonance image (MRI) finding (no discernible enhancing, non-mass enhancement, and multifocal tumor), and use of acellular dermal matrix (ADM).

Results :

Mean age was 44.8±7.6 years and mean BMI was 22.5±2.9 kg/m2. Patients with smoking history was 4.3% (n=11). Mean implant size was 242.3±57.7mL. Patients underwent chemotherapy in 39% (n=99) and radiotherapy in 29.1% (n=74). Compared to western studies, our patients showed lower BMI, less history of smoking, and smaller size of implant insertion. Overall post-operative complication rate was 8.3% (n=23) and the complication rate was similar to the results of western studies; which included wound dehiscence (4.3%, n=12), infection (2.9%, n=8), and implant loss (2.9%, n=8). The use of ADM was independently associated with post-operative complications (30.0% in patients used ADM vs 6.6% in patients without ADM, respectively; OR, 6.016, 95% CI, 2.018-17.939; p=0.001). Other factors were not significantly related to post-operative complications.

Conclusions :

Our study is the largest study to investigate the risk factors for post-operative complications after IBR with implant in Asian countries. Compared to western studies, the patients had lower BMI, less history of smoking and smaller size of implant. Although known risk factors, such as smoking, obesity and size of implant, were not significantly associated with post-operative complication in our study, the incidence of post-operative complication was similar to that of western studies. These results might be caused by higher post-operative complication rate after use of ADM compared with western studies. Further study is warranted to evaluate the impact of ADM on post-operative complication on Asian countries.

Citation Format: Park SJ, Choi JH, Lee MH, Jung S-Y, Lee ES. Risk factors affecting post-operative complication after immediate reconstruction with implant for operable breast cancer patients [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-14-11.