Literature DB >> 19110479

Immediate breast reconstruction in the elderly: can it be considered an integral step of breast cancer treatment? The experience of the European Institute of Oncology, Milan.

Francesca De Lorenzi1, Mario Rietjens, Massimo Soresina, Fabio Rossetto, Riccardo Bosco, Anna Rita Vento, Simonetta Monti, Jean Y Petit.   

Abstract

BACKGROUND: In the last few decades, breast reconstruction often has not been offered to the elderly population due to the reluctance of clinicians concerned about serious co-morbidities. This study aims to demonstrate that breast reconstruction is feasible and safe in the elderly cohort.
METHODS: Between 1999 and 2004, 63 elderly patients underwent an immediate reconstruction after breast cancer treatment at the European Institute of Oncology. A conservative treatment, combined with breast repair by plastic surgical techniques, was performed in 14 patients. In the remaining 49 patients, a modified radical mastectomy was necessary in 30 breasts, a total mastectomy in 19, a subcutaneous mastectomy in one case and a radical mastectomy in one patient. Three nipple-sparing mastectomies, along with intra-operative radiotherapy, were performed in two patients. A definitive silicone implant was used in 41 breasts and a skin expander in eight cases. A latissimus dorsi flap was performed in two patients, a pedicled transverse rectus abdominis muscle (TRAM) flap in two cases and a local advancement fasciocutaneous flap in another two patients.
RESULTS: In all patients, surgery was well tolerated despite patient age. No systemic and medically unfavourable events occurred in the immediate and late postoperative period. Infection occurred in four patients (6.34%) and partial necrosis of the mastectomy flaps in three cases (5.5% of the mastectomies). Capsular contracture grade III and IV was reported in four cases (8.89%). Total implant removal was rated 12.24%, due to infection (three prostheses), exposure (one expander) and capsular contracture grade IV (two implants).
CONCLUSIONS: Implant-based technique of breast reconstruction should be made available to the elderly population. (c) 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

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Year:  2008        PMID: 19110479     DOI: 10.1016/j.bjps.2008.11.054

Source DB:  PubMed          Journal:  J Plast Reconstr Aesthet Surg        ISSN: 1748-6815            Impact factor:   2.740


  4 in total

1.  Update on breast reconstruction techniques and indications.

Authors:  Jean-Yves Petit; Mario Rietjens; Visnu Lohsiriwat; Piercarlo Rey; Cristina Garusi; Francesca De Lorenzi; Stefano Martella; Andrea Manconi; Benedetta Barbieri; Krishna B Clough
Journal:  World J Surg       Date:  2012-07       Impact factor: 3.352

Review 2.  Breast reconstruction in the high-risk population: current review of the literature and practice guidelines.

Authors:  Margaret S Roubaud; Joseph N Carey; Emma Vartanian; Ketan M Patel
Journal:  Gland Surg       Date:  2021-01

Review 3.  Outcomes in Deep Inferior Epigastric Perforator Flap and Implant-Based Reconstruction: Does Age Really Matter?

Authors:  Lauren V Kuykendall; Angie Zhang; Bugra Tugertimur; Sara Bijan; Corin Agoris; Ambuj Kumar; Deniz Dayicioglu
Journal:  Cancer Control       Date:  2018 Jan-Mar       Impact factor: 3.302

4.  Sub-Muscular Direct-to-Implant Immediate Breast Reconstruction in Previously Irradiated Patients Avoiding the Use of ADM: A Preliminary Study.

Authors:  Lucrezia Pacchioni; Gianluca Sapino; Irene Laura Lusetti; Giovanna Zaccaria; Pietro G Di Summa; Giorgio De Santis
Journal:  J Clin Med       Date:  2022-10-03       Impact factor: 4.964

  4 in total

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