ORIGINAL ARTICLE   

Minerva Chirurgica 2017 June;72(3):188-99

DOI: 10.23736/S0026-4733.17.07314-X

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

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

William SEIDEL ^{1, 2}, Jorge BINS-ELY ¹, Daniel ONGARATTO BARAZZETTI ¹, Renata DELLA GIUSTINA ³, Gustavo P. WALTER ^{1, 2}, Thiago A. FERRI ^{1, 2}, Rosemeri MAURICI ², Janaína L. NARCISO-SCHIAVON ^{2, 3} ✉

¹ Plastic Surgery Unit, University Hospital Polydoro Ernani de São Thiago, Federal University of Santa Catarina, Florianópolis, Brazil; ² Postgraduate Program in Intensive and Palliative Care, Centre of Health Sciences, Federal University of Santa Catarina, Florianópolis, Brazil; ³ Gastroenterology and Hepatology Unit, Federal University of Santa Catarina, Florianópolis, Brazil

BACKGROUND: Early reconstruction after mastectomy for breast cancer with definitive implants has been widely used, especially with the evolution of conservative surgical breast cancer treatments. We aimed to identify different characteristics associated with plastic surgery, based on immediate or delayed reconstruction time and evaluate quality of life in patients undergoing mastectomy for cancer.
METHODS: This is a cross-sectional analytical study that evaluated adult patients undergoing mastectomy for breast cancer and breast reconstruction in Plastic Surgery Service at a tertiary hospital.
RESULTS: Between March 2011 and November 2015, 58 patients who underwent mastectomy were included, with a mean age of 51.6±10.6 years and 98.3% of them being women. Eighty percent of the patients underwent a radical mastectomy and 20% underwent segmentectomies. Immediate and delayed surgical reconstructions occurred in 22.4% and 77.6% of the cases, respectively, including immediate reconstruction with the local flap trade (15.5%), immediate reconstruction with prosthesis (6.9%), transverse rectus abdominis myocutaneous (TRAM) flap (6.9%), delayed reconstruction with local flap (8.6%), expander and prosthesis (35.7%), and reconstruction with latissimus dorsi flap and prosthesis (22.4%). When comparing subjects undergoing reconstructive surgery based on timing of reconstruction, it was observed that patients undergoing delayed breast reconstruction surgery presented a higher proportion of radical mastectomy (90.7% vs. 41.7%; P=0.001) and the need for two or more surgical interventions (64.1% vs. 20.0%; P=0.029). There was no difference in the quality of life according to reconstruction time.
CONCLUSIONS: The characteristics associated with postmastectomy reconstruction timing are related to preoperative factors such as the procedure employed and the number of interventions performed and have no influence on complications or the quality of life.

KEY WORDS: Palliative care - Breast neoplasms - Mammaplasty - Surgery, plastic