There are many advantages of immediate breast reconstruction.  These include a shorter recovery time, better cosmetic results, decreased costs, and psychological benefits.  However, controversy continues with some plastic surgeons feeling that immediate reconstruction can be unsafe or
causes an unacceptable delay in additional treatments.

A recent study looked at the safety of immediate breast reconstruction after mastectomy for breast cancer.  The study was published in the July edition of Plastic and Reconstructive Surgery.  The authors were from the Division of Plastic Surgery at UCLA Medical Center and the Plastic and Reconstructive Surgery Service at Memorial Sloan Kettering Cancer Center.

The study looked at 170 women with advanced breast cancer (stage IIb or higher) who underwent immediate reconstruction after mastectomy.  Thirteen women had reconstruction of both breasts.  The study covered a ten year period.  The majority of patients underwent reconstruction with free flaps from the abdomen.

The authors analyzed complication rates, cosmetic results, and timing of adjuvant treatments.

 

 

 

 

 

 

 

 

 

The purpose of the study was to determine if the benefits of immediate reconstruction were justified in regards to complication rates.

There were 15 major complications, a rate of 8.8%.  Eight patients (4.7%) had a delay in further treatments because of a complication.  The maximum delay was three weeks.

Of the 170 patients, 15 women had a recurrence of their breast cancer.  Immediate reconstruction did not appear to lead to a delay in diagnosis of these recurrences.

A total of 69 women underwent radiation therapy after their reconstruction. A 30% rate of minor flap shrinkage was seen after long term follow up.  Roughly ten percent of these patients had severe flap distortion after radiation.  The overall cosmetic result appeared to be similar for those patients who did and did not receive radiation.

This study is one of the largest to date looking at outcomes after immediate reconstruction.  It draws the conclusion that immediate breast reconstruction is safe and effective.  There was no unacceptable increase in complication rates.

Delays in further treatment appeared similar to those of women who undergo mastectomy without reconstruction.  The vast majority of patients had no or only minor complications related to radiation.

More information on breast reconstruction can be found here.