Greater Satisfaction With Autologous Breast Reconstruction
THURSDAY, June 21, 2018 -- Patients undergoing autologous post-mastectomy breast reconstruction have greater satisfaction than those undergoing implant reconstruction, and the odds of developing complications are significantly higher for autologous reconstruction types versus expander-implant techniques, according to two studies published online June 20 in JAMA Surgery.
Katherine B. Santosa, M.D., from the University of Michigan Health System in Ann Arbor, and colleagues examined patient-reported outcomes for women undergoing post-mastectomy breast reconstruction using implant or autologous techniques. A total of 2,013 women (1,490 implant and 523 autologous tissue reconstruction) were included; all patients had two years of follow-up. The researchers found that, compared with patients who underwent implant reconstruction, those who underwent autologous reconstruction had significantly greater satisfaction with their breasts, psychosocial well-being, and sexual well-being at two years.
Katelyn G. Bennet, M.D., from the University of Michigan in Ann Arbor, and colleagues examined two-year complications across common techniques for post-mastectomy reconstruction among 2,343 patients. The researchers found that the overall complication rate was 32.9 percent, with reoperative complications and wound infections in 19.3 and 9.8 percent, respectively. Compared with patients undergoing expander-implant reconstruction, the odds of developing any complications were increased for patients undergoing any autologous reconstruction type two years after surgery. Compared with expander-implant techniques, all flap procedures except latissimus dorsi flap had higher odds of reoperative complications.
"These studies are vital in shared decision making, assuming that patients are candidates for both autologous and prosthetic breast reconstruction," write the authors of an accompanying editorial.
One author of the Santosa study was codeveloper of the BREAST-Q.
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Posted: June 2018