Breast reconstruction after mastectomy for breast cancer: comparative analysis of early and delayed reconstruction

Seidel, William T.; Ely, Jorge Bins; Barazzetti, Daniel Ongaratto; Giustina, Renata Della; Walter, Gustavo Palmeiro; Ferri, Thiago Alessandro; Silva, Rosemeri Maurici da; Narciso-Schiavon, Janaína Luz

doi:10.23736/s0026-4733.17.07314-x

Cited by 4 publications

(3 citation statements)

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“…Implant-based reconstructions consist of roughly two-thirds of reconstruction cases and may provide a safe alternative and be less of a burden for patients than the prolonged operative and postoperative course often associated with autologous-based options. 4,5 Although two-staged reconstruction with tissue expanders at the time of mastectomy remains a common approach, [6][7][8][9] direct-to-implant (DTI) reconstruction has become more popular in the past decade‚ with skin-and nipple-sparing mastectomies more commonly used by breast surgeons, and acellular dermal matrix available for implant support. 10 Advantages of the DTI breast reconstruction may include a reduction in overall health care cost to both the patient and health care system, fewer total procedures, increased patient satisfaction, immediate psychosocial benefits, and overall improvements in quality of life.…”

Section: Introductionmentioning

confidence: 99%

The Safety of Same-day Discharge after Immediate Alloplastic Breast Reconstruction: A Systematic Review

Marxen

Shauly

Losken

2022

Plastic and Reconstructive Surgery - Global Open

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Background: Implant-based breast reconstruction can be accomplished in a variety of ways and can result in vastly different postoperative experiences for patients. The COVID-19 pandemic and recent trends have resulted in a shift toward outpatient management of these patients. Methods: A systematic review of PubMed and Embase databases was conducted. A total of 1328 articles were identified on initial search, and after several rounds of review, a total of four met inclusion and exclusion criteria. Manuscripts were included if postmastectomy alloplastic breast reconstruction was performed, and there was documentation of same-day discharge. This cohort of patients was compared with traditional, planned overnight admission cohorts found in the literature. Objective data compared between groups included preoperative patient factors and postoperative complication rates. Results: Four studies representing data on a total of 574 patients were included: 289 were same-day discharge and 285 were overnight admission. Patient characteristics of body mass index, radiation, smoking, and bilateral procedures were comparable. Tissue expanders were used more frequently than implants in both cohorts. The rate of overall complications was 33% for same-day discharge and 34% for overnight admission. Rates of major and minor complications, including infection, seroma, and hematoma, were similar. There was no increase in reoperations or readmissions reported in any of the studies. Conclusions: Same-day discharge after mastectomy with immediate alloplastic reconstruction is a safe approach to treatment in both the ambulatory and hospital setting. There are comparable rates of common complications such as infection, seroma, and hematoma, with no increase in readmission or reoperation.

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Section: Introductionmentioning

confidence: 99%

The Safety of Same-day Discharge after Immediate Alloplastic Breast Reconstruction: A Systematic Review

Marxen

Shauly

Losken

2022

Plastic and Reconstructive Surgery - Global Open

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“…Factors associated with postmastectomy reconstruction timing, such as preoperative factors (procedure type and number of interventions), have no impact on complications or quality of life. Immediate and delayed reconstructions have shown comparable quality-of-life outcomes in patients undergoing mastectomy for breast cancer [5]. This review aims to assess the application of hypofractionated proton therapy in breast cancer reconstruction, analyzing its advantages, challenges, and broader implications for patient care.…”

Section: Introductionmentioning

confidence: 99%

Balancing Innovation and Patient Care in Breast Cancer: Integrating Hypofractionated Proton Therapy With Breast Reconstruction Outcomes

Fatima,

Abbas,

Alshehri

2024

Cureus

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This review aims to assess the application of hypofractionated proton therapy in breast cancer reconstruction, analyzing its advantages, challenges, and broader implications for patient care. The goal is to comprehensively understand how this innovative approach can be integrated into breast cancer treatment. Proton therapy exhibits superior target coverage and safety, reducing radiation-induced complications and sparing critical organs, but skin toxicity outcomes differ from photon therapy. Tissue expanders are vital in breast reconstruction, employing innovative planning for positive long-term outcomes and highlighting the importance of balancing cancer treatment effectiveness with cosmetic outcomes. Hypofractionated proton therapy and breast cancer reconstruction present promising innovations with notable advantages in target coverage and organ sparing. However, variations in skin toxicity outcomes and the need for a careful balance between treatment effectiveness and cosmetic outcomes underscore ongoing challenges. Future directions should focus on refining treatment protocols, optimizing patient selection criteria, and integrating emerging technologies to enhance therapeutic outcomes while minimizing adverse effects.

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“…BR can be performed immediately after a mastectomy or delayed according to each woman’s preferred timing after all required treatments have been completed [ 8 ]. Furthermore, various kinds of BR options (including implants and autologous) and surgical techniques (including traditional and endoscope assisted) can be used to perform the surgery [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Effectiveness of a Decision Support App (Pink Journey) for Women Considering Breast Reconstruction Surgery: Pilot Randomized Controlled Trial

Fang¹,

Lin²,

Kuo³

2021

JMIR Mhealth Uhealth

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Background Various kinds of breast reconstruction (BR) options, including implants and autologous, and surgery techniques, including traditional and endoscope assisted, can be used to perform surgery. All options have their own advantages and disadvantages. Women decide on an option depending on the values and preferences they emphasize. Lacking knowledge about BR or having decision difficulties during the treatment decision process makes women experience more decision regret, psychological distress, and poor body image. Delivering decision support with a values clarification exercise using eHealth approaches would be beneficial for patient outcomes. Objective This study aims to examine the effects of a decision support app on decision-making quality and psychological morbidity for women considering BR surgery. Methods This randomized controlled trial included women who were over 20 years of age and were newly diagnosed with breast cancer and candidates for mastectomy. Women having an option for breast conservation were excluded. After being referred from the outpatient physician, the women provided consent and completed the baseline assessment. Women allocated to the control group (CG) received usual care and were provided with a pamphlet with information about types of surgery and the advantages and disadvantages of different surgery types. Women allocated to the intervention group (IG) were given the same pamphlet and guided to use the Pink Journey app to support their decision. Then they were also prompted to discuss the opinions with their significant others. Finally, the decision-making process of using the app was printed out for women that they could take home. Decision conflict, anxiety, and depression were measured at baseline. At 1 week after the intervention (T1) and at 1 month (T2), 8 months (T3), and 12 months (T4) after surgery, the women completed decision conflict, decision regret, anxiety, depression, and body image scales. An intention-to-treat analysis was performed. Results From February 2018 to July 2019, 96 women were randomly assigned to the CG (n=48) or the IG (n=48). Results revealed that body image distress declined significantly for the IG but increased for the CG. The interaction of time and group also reached significance, indicating a significant decrease in body image distress from baseline in the IG compared with the CG after the 12th month (T4) follow-up (β=–2.25, standard error=1.01, P=.027). However, there was no significant difference in decision conflict (P=.21-.87), decision regret (P=.44-.55), anxiety (P=.26-.33), and depression (P=.20-.75), indicating that the decrease in these outcomes in the IG was not greater than those in the CG. Conclusions Although we found no effect on decision conflict, decision regret, anxiety, and depression, a decision aid that combines surgery information and values clarification can help women reduce their body image distress. Trial Registration ClinicalTrials.gov NCT04190992; https://clinicaltrials.gov/ct2/show/NCT04190992

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Breast reconstruction after mastectomy for breast cancer: comparative analysis of early and delayed reconstruction

Cited by 4 publications

References 0 publications

The Safety of Same-day Discharge after Immediate Alloplastic Breast Reconstruction: A Systematic Review

The Safety of Same-day Discharge after Immediate Alloplastic Breast Reconstruction: A Systematic Review

Balancing Innovation and Patient Care in Breast Cancer: Integrating Hypofractionated Proton Therapy With Breast Reconstruction Outcomes

Long-Term Effectiveness of a Decision Support App (Pink Journey) for Women Considering Breast Reconstruction Surgery: Pilot Randomized Controlled Trial

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