Obese patients who underwent oncoplastic breast reconstruction after mastectomy experienced fewer major complications compared with patients who underwent immediate breast reconstruction, according to recent data.
“This finding supports the role of oncoplastic breast reconstruction in the treatment of obese patients, particularly in patients with medical comorbid conditions and higher degrees of obesity,” Winnie M. Y. Tong, MD, from the departments of plastic surgery and breast surgical oncology at the The University of Texas M. D. Anderson Cancer Center, and colleagues wrote. “The benefits of a one-stage reconstruction before the delivery of radiation therapy over a multistage reconstruction delivered after radiation therapy and avoiding the significant risk of infection with the use of implants in obese patients cannot be overstated. Collaboration among breast surgeons, radiation oncologists and plastic surgeons will enhance patient selection and counseling and maximize the use of oncoplastic breast reconstruction in the multidisciplinary care of the obese breast cancer patient.”
Tong and colleagues evaluated 408 patients with a BMI of at least 30 kg/m2 who underwent either oncoplastic (131 patients; mean age, 55 years) or immediate breast reconstruction (277 patients; mean age, 53 years) between January 2005 and April 2013 at a single center. The patients had similar stages of breast cancer, with patients in the oncoplastic group having a mean BMI of 37 kg/m2 compared with a mean BMI of 35 kg/m2 in the immediate reconstruction group.
Although patients in the oncoplastic group had more comorbidities, the researchers found that group had fewer major complications (3.8%) compared with the immediate reconstruction (28.5%) group (P < 0.001). The oncoplastic group also had fewer complications that delayed adjuvant therapy (0.8%) compared with the immediate reconstruction (14.4%) group (P < 0.001) and fewer hematomas and seromas (3.1%) compared with the immediate construction (11.6%) group (P < 0.004).
Tong and colleagues noted that the oncoplastic group was independently protective of major complications (OR = 0.1; P < 0.001) and types of complications that would delay adjuvant therapy (OR = 0.05; P = 0.002), according to the abstract. – by Jeff Craven
Disclosure: The researchers report no relevant financial disclosures.