Abstract P2-14-02: Complications of breast reconstruction in a provincial population of breast cancer survivors
Authors: Wai Elaine S , Lu Ling Hong , Alexander Cheryl , Lesperance Mary L , McBride Mary L , Tyldesley Scott , Taylor Chris 
Published: May 2015

Background: Breast cancer is the most prevalent cancer in women in Canada. There are varying reports of the use of breast reconstruction in various populations and very few prospective trials or population reports of complications related to breast reconstruction in breast cancer patients. The goal of this study is to describe the use of breast reconstruction in breast cancer survivors in British Columbia, the risk of complications after breast reconstruction, and factors associated with a higher risk of complications.

Methods: Electronic Records from the BC Cancer Agency were used to identify women diagnosed with invasive breast cancer between 2001-2008 in British Columbia. Administrative hospital records used with permission of the British Columbia Ministry of Health, obtained through PopulationData BC, were used to obtain details about all surgeries,hospital admissions and associated complications for the cohort. Analyses of reconstruction for those treated with breast-conserving surgery (BCS) versus mastectomy were done separately. For those who underwent mastectomy following BCS, complications after BCS before mastectomy were attributed to the BCS, and those that occurred after mastectomy were attributed to the mastectomy. These analyses included a description of the type of reconstruction procedures used in this era, and the frequency and types of complications after the reconstruction procedures. Logistic regression was used to identify risk factors for complications post reconstruction.

Results: The cohort consisted of 18,642 women; 4868 had mastectomy alone, 8633 had BCS alone, 2894 had both, and 2247 had neither surgery.

Of those undergoing BCS (11527), 746 had reconstructive procedures. Most of these were separate procedures; 55% were ≤50 years of age. The most common complication was "miscellaneous complication of internal prosthetic devices, implants or grafts". One hundred eight (14%) of those with reconstruction after BCS had complications within 30 days of the reconstruction procedure, 134 (18%) had complications within one year of the procedure.

Of those undergoing mastectomy (7762), 7497 had their mastectomies within 1 year of diagnosis. Ninety-six had bilateral mastectomies. 1766 underwent reconstructive procedures; 74% were immediate procedures, 57% were ≤ 50 years of age. The most common complication was "miscellaneous complication of internal prosthetic devices, implants or grafts". One hundred sixty-seven (9%) of those with reconstruction after (or with) mastectomy had complications within 30 days of the reconstruction procedure, 227 (13%) had complications within one year of the procedure. Regression analysis showed that no radiotherapy (OR=0.65) and premenopausal status (OR=0.70) were significantly associated with a lower risk of complication post reconstruction.

Conclusion: Complications related to reconstructive procedures for breast cancer happened in the minority of breast cancer survivors. They were more common in those with BCS, and were more likely for those who underwent adjuvant radiotherapy or were postmenopausal.

Citation Format: Elaine S Wai, Ling Hong Lu, Cheryl Alexander, Mary L Lesperance, Mary L McBride, Scott Tyldesley, Chris Taylor. Complications of breast reconstruction in a provincial population of breast cancer survivors [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P2-14-02.