Complications After Immediate Implant-Based Breast Cancer Reconstruction
Posted: Monday, March 25, 2019
Complications after immediate implant-based breast reconstruction for patients with breast cancer who had undergone mastectomy were higher than considered acceptable by U.K. national standards, according to findings presented in The Lancet Oncology. Shelley Potter, PhD, of the Bristol Centre for Surgical Research, and colleagues observed that short-term safety outcomes for these women involved smoking and high body mass index but not the use or type of mesh.
“There is an urgent need to address this to improve outcomes for patients,” Dr. Potter told JNCCN 360. “Our study…strongly supports the need for a large-scale pragmatic randomized clinical trial to establish the optimal approach to implant-based breast reconstruction.”
In the prospective, multicenter cohort study, the researchers recruited women who had any type of immediate implant-based breast reconstruction for malignancy or risk reduction, with any technique, at breast and plastic surgical units in the United Kingdom. In total, between February 2014 and June 2018, 2,108 patients had 2,655 mastectomies. Of those patients, 1,650 had planned single-stage reconstruction, 1,376 had reconstruction with biologic or synthetic mesh, 440 had dermal sling implants, 181 had nonmesh submuscular or subfascial implants, 42 had prepectoral implants, and 79 had other or a combination of implants.
Outcome data were available for 2,081 patients. The investigators found that 372 patients (18%) required readmission to the hospital, 370 patients (18%) required return to the hospital for complications within 3 months of initial surgery, and 182 patients (9%) experienced implant loss. Additionally, 522 patients (25%) required treatment for an infection. According to the authors, all of these rates are higher than the National Quality Standards in the United Kingdom (less than 5% for reoperation, readmission, and implant loss; and less than 10% for infection).
Disclosure: The study authors’ disclosure information can be found at thelancet.com.