Trends in breast reconstruction practices in a specialized breast tertiary referral centre

Abstract

BackgroundBreast reconstruction is an important component of multidisciplinary breast cancer management. The practice of breast reconstruction after mastectomy has evolved significantly in the past decade as a result of both increasing mastectomy rates and advances in reconstructive strategy. These changes have significantly influenced the contemporary surgical management of breast cancer. The aim of this study was to examine trends in breast reconstruction after mastectomy in an Irish population.MethodsData were reviewed from a database of all patients who had mastectomy with or without breast reconstruction at Galway University Hospital, a tertiary breast cancer referral centre, between 2004 and 2014. Trends in breast reconstruction after mastectomy were explored with respect to patient demographics, clinicopathological features, and neoadjuvant and adjuvant therapy.ResultsOf 1303 patients who underwent mastectomy during interval studied, 706 (54.2 per cent) had breast reconstruction after mastectomy. In 629 patients (89·1 per cent), breast reconstruction was performed in the immediate setting. Reconstruction rates increased over time from 20·5 per cent in 2004 to 44·7 per cent in 2014. Reconstruction was more commonly performed in younger patients and those with benign, in situ and early‐stage disease. A negative relationship between radiotherapy and reconstruction was observed. A pedicled flap with or without an implant was the most commonly used reconstructive approach in patients receiving radiotherapy.ConclusionBreast reconstruction after mastectomy has become the standard of care in the surgical treatment of breast cancer. Recent trends show a transition favouring implant‐based approaches.

Inquiry and computer program Onko-Online: 25 years of clinical registry for breast cancer at the University Medical Centre Maribor

“…In the inquiry section covering a surgical procedure, breast reconstruction was not included, since this type of procedure was performed at the Department of Plastic and Reconstructive Surgery at the University Medical Centre Maribor and not within our department. Breast reconstruction is an important part of breast cancer management which has evolved significantly in the past decades because of advances in reconstructive strategy 23. It is oncologically safe and associated with high satisfaction rates 24.…”

Immediate and delayed autologous abdominal microvascular flap breast reconstruction in patients receiving adjuvant, neoadjuvant or no radiotherapy: a meta-analysis of clinical and quality-of-life outcomes

“…Adjuvant radiotherapy (PMRT) may have deleterious effects on breast cosmetic outcomes, quality of life (QOL) and surgical complications after immediate BRR. Previous studies evaluating the impact of PMRT on types of immediate BRR showed its potential feasibility in this setting, with lower morbidity rates compared with those of implant‐based procedures.…”

“…Previous studies evaluating the impact of PMRT on types of immediate BRR showed its potential feasibility in this setting, with lower morbidity rates compared with those of implant‐based procedures. Surprisingly, the rapid adoption of immediate implant‐based reconstruction in about 70 per cent of women, compared with 34 per cent of autologous procedures when PMRT is recommended, may be influenced by surgeon and patient preferences, regardless of current evidence.…”

Oncological Risk in Autologous Stem Cell Donation for Novel Tissue-Engineering Approaches to Postmastectomy Breast Regeneration

“…Breast reconstruction improves psychosocial and quality-oflife outcomes for the 40% of breast cancer patients who will require mastectomy to achieve locoregional disease control. 1,2 Rates of mastectomy are currently increasing secondary to increased diagnosis of BRCA and other high-risk genetic mutations and an increased demand for contralateral prophylactic mastectomy. [3][4][5] There is also an increasing trend for patients who are eligible for breast-conserving surgery to opt for mastectomy.…”