Many patients with breast cancer choose to undergo breast reconstruction following mastectomy. For some women over the age of 65, there has been concern for an increased risk of complications, but a new study from NorthShore University HealthSystem and the University of Chicago indicates otherwise.
“Older patients should be counseled that their age does not confer an increased risk of complications after implant-based post-mastectomy breast reconstruction,” wrote Mark Sisco, MD, in the study published in Plastic and Reconstructive Surgery, as reported by a news release from the publishing journal.
The study, “Advanced Age Is a Predictor of 30-Day Complications after Autologous but Not Implant-Based Postmastectomy Breast Reconstruction,” did identify an increased risk of complications due to blood clots following tissue-based (autologous) breast reconstruction.
To conduct the research, Dr. Sisco and his team used The American College of Surgeons National Surgery Quality Improvement Program Participant Use Files database to identify breast cancer patients undergoing a unilateral mastectomy with or without immediate reconstruction between the years of 2005 and 2012. In total, 40,769 women were identified, 15,093 of whom were older than 65 years. Older women were less likely to undergo reconstruction: 10.8% opted for the surgery, compared to 3.5% of younger women.
Analyzing the outcomes of patient surgeries and follow-ups, the researchers identified more complications in patients undergoing breast reconstruction than in patients who chose mastectomy alone (6.8% compared to 5.2%). There was no difference between age groups, as the risk for complications was comparable among women receiving implants.
A difference did arise when the researchers compared autologous reconstruction to implant-based reconstruction. Older women were nearly four times as likely to experience venous thromboembolism (VTE) if older than 65 years, and this figure increased to six times as likely if patients were between the ages of 70 and 75 years. However, the complication rate remained low, with under 1% of autologous reconstruction patients experiencing VTE.
These results are beneficial for women who are considering breast reconstruction following mastectomy. “[Breast reconstruction] is an important option for women undergoing mastectomy and may improve patient self-esteem, body image, and quality of life,” stated the authors. Older women should be able to experience these benefits without fear of an increased risk of complications following surgery.
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