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. 2024 Sep 3;8(5):zrae095.
doi: 10.1093/bjsopen/zrae095.

Surgical complications after immediate implant-based breast reconstruction for breast cancer in women over 65 years

Yihang Liu  1   2 , Anna L V Johansson  3   4 , Ira Oikonomou  5 , Axel Frisell  6 , Hannah C Adam  7 , Dhirar Ansarei  8 , Martin Halle  1   9 , Helena Sackey  1   10 , Jana de Boniface  1   11
Affiliations

Surgical complications after immediate implant-based breast reconstruction for breast cancer in women over 65 years

Yihang Liu et al. BJS Open. .

Abstract

Background: While immediate breast reconstruction rates in breast cancer are increasing, they remain low in women over 65 years old. The aim was to investigate surgical outcomes in women older than 65 years receiving implant-based immediate breast reconstruction.

Method: The population-based Stockholm Breast Reconstruction Database includes all adult women with breast cancer receiving an implant-based immediate breast reconstruction in Stockholm, Sweden, 2005-2015. Primary outcomes within 30 days from immediate breast reconstruction were: infection requiring antibiotics and reoperation on. Implant removal was a secondary outcome. Women more than 65 years were compared with younger age groups. Chi-square tests and multivariable logistic regression were applied for the primary outcomes, and Kaplan-Meier analysis for the secondary outcome.

Results: Among 1749 cases of immediate breast reconstruction, 140 (8.0%) were in women more than 65 years. Median follow-up was 74 months (1-198). Postoperative infection was not more common in women older than 65 years old (22 of 140, 15.7%) than in women under 65 years old (303 of 1609, 18.8%; P = 0.221). Reoperation on was more frequent in women older than 65 years than in other age groups (more than 65: 8.6%; 50-64: 6.5%; 40-49: 3.5%; less than 40: 1.6%; P < 0.001), however, age older than 65 years was not an independent risk factor in the multivariable analysis (OR 1.00, 95% c.i. 0.44 to 2.28). Overall, 6-year probability of implant removal was 11.4%, (8.1% due to complications and 3.3% due to patient preference). There was no statistically significant difference between age groups for either reason (P = 0.085 and P = 0.794 respectively).

Conclusion: Older age alone was not associated with worse surgical outcomes after implant-based immediate breast reconstruction in highly selected patients older than 65 years when compared with their younger counterparts.

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Figures

Fig. 1
Fig. 1
Cumulative implant removal rates for each age category Follow-up was truncated at 6 years for all patients.
See this image and copyright information in PMC

References

    1. De La Cruz Ku G, Karamchandani M, Chambergo-Michilot D, Narvaez-Rojas AR, Jonczyk M, Príncipe-Meneses FS et al. Does breast-conserving surgery with radiotherapy have a better survival than mastectomy? A meta-analysis of more than 1,500,000 patients. Ann Surg Oncol 2022;29:6163–6188 - PubMed
    1. Nationella Kvalitetsregistret för Bröstcancer (NKBC) . Interactive Statistics. Stockholm: Regional Cancer Center (RCC), 2022. https://statistik.incanet.se/brostcancer/
    1. Ten Wolde B, Kuiper M, De Wilt JHW, Strobbe LJA. Postoperative complications after breast cancer surgery are not related to age. Ann Surg Oncol 2017;24:1861–1867 - PubMed
    1. Zhu M, Mao J, Fang J, Chen D. Risk factors for severe complications and salvage management in direct-to-implant immediate breast reconstruction: a retrospective study. Medicine (Baltimore) 2024;103:e37365. - PMC - PubMed
    1. Angarita FA, Dossa F, Zuckerman J, McCready DR, Cil TD. Is immediate breast reconstruction safe in women over 70? An analysis of the national surgical quality improvement program (NSQIP) database. Breast Cancer Res Treat 2019;177:215–224 - PubMed

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