Breast reconstruction can benefit older women and young women equally after mastectomy

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Breast reconstruction after mastectomy

Of the nearly 250,000 women to be diagnosed with breast cancer in 2016, 40% will be 62 years of age or older.

One usual way to treat breast cancer is mastectomy, which is the surgical removal of one or both breasts, partially or completely.

Although the use of mastectomy in the treatment of breast cancer has increased over the last 10 years, older women are less likely to have the procedure than younger ones.

Now a new study shows that older women enjoy the same benefits from breast reconstruction following mastectomy as younger women without a significant increase in the risk for complications.

The finding is published online in the Journal of the American College of Surgeons.

Researchers evaluated clinical and patient-reported outcomes two years after women underwent mastectomy and breast reconstruction for breast cancer.

A total of 1,531 women who had the surgery at one of 11 institutions in the US and Canada participated in this Mastectomy Reconstruction Outcomes Consortium (MROC) study.

The study categorized patients by age group: 494 were younger (less than 45 years of age); 803 were middle-aged (between 45 and 60 years); and 234 were older (more than age 60).

The researchers determined overall rates for any type of complication as well as any major complication that required hospital admission or surgical exploration.

In addition, they compiled information about patient-reported outcomes using the BREAST-Q Reconstructive Module.

BREAST-Q is a validated data-gathering instrument that has been widely used to assess patient satisfaction and patients’ perceptions of psychosocial, physical, and sexual well-being following breast reconstruction.

The result showed that complication rates were varied by surgical procedure (i.e., insertion of a surgical implant vs. use of a patient’s own tissue).

Among women who received a surgical implant, the rate for any complication was 22% in the younger age group, 27% in the middle-aged group, and 29% in the older group.

The rate for a major complication among women who had an autologous procedure was 33% in younger women, 29% in the middle-aged, and 31% in older women.

Only one group of women expressed a slight decline in their satisfaction after breast reconstruction.

Older women who had implant surgery had a BREAST-Q satisfaction score of 60.9 preoperatively and a score of 59.2 afterward.

All other groups of women were just as satisfied with their breasts after reconstruction as they were before undergoing the procedure.

Surgeons and patients may have preconceived notions that breast reconstruction is not as good an option in older women as it is in younger patients.

According to findings from this study, reconstruction provides the benefits it is expected to provide for quality of life and body image, and age did not significantly affect complications.

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Citation: Santosa KB, et al. (2016). Effect of Patient Age on Outcomes in Breast Reconstruction: Results from a Multicenter Prospective Study. Journal of the American College of Surgeons, published online.  DOI: http://dx.doi.org/10.1016/j.jamcollsurg.2016.09.003.
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