BACKGROUND: Breast-conserving surgery with adjuvant radiation therapy (BCT) has been established as safe oncologically. Oncoplastic breast surgery uses both oncologic and plastic surgery techniques for breast conservation to improve cosmetic outcomes. We evaluated the risk factors associated with complications after oncoplastic breast reduction. METHODS: A single-institution, institutional review board-approved, retrospective review of electronic medical records of female patients with breast cancer who underwent oncoplastic breast reduction from 2008 to 2014. A review of electronic medical records collected relevant medical history, clinical and pathological information, and data on postoperative complications within 6 months stratified into major or minor complications. Categorical variables analyzed with the χ2 exact method; continuous variables were analyzed with the Wilcoxon rank sum test exact method. RESULTS: We identified 59 patients; 4 required re-excision for positive margins, and 1 moved on to completion mastectomy. The overall complication rate was 33.9% (n = 20): 12 major (20.3%) and 8 minor (13.6%). Of the continuous variables (age, body mass index, and tissue removed), increased age was associated with minor complications (P = 0.02). Among the categorical variables (stratified body mass index, prior breast surgery, hypertension, diabetes mellitus, hyperlipidemia, vascular disease, pulmonary disease, and stratified weight of tissue removed), none were associated with overall or major complications. Pulmonary disease was associated with minor complications (P = 0.03). Bilateral versus unilateral oncoplastic breast reduction showed no statistically significant increase in complications. CONCLUSIONS: The overall complication rate after oncoplastic breast reduction was markedly higher than that in nationally published data for breast-conserving surgery. The complication rate resembled more closely the complication rate after bilateral mastectomy with immediate reconstruction. No risk factors were associated with major or overall complications. Age and pulmonary disease were associated with minor complications. Patients should be selected and counseled appropriately when considering oncoplastic breast reduction.
BACKGROUND: Breast-conserving surgery with adjuvant radiation therapy (BCT) has been established as safe oncologically. Oncoplastic breast surgery uses both oncologic and plastic surgery techniques for breast conservation to improve cosmetic outcomes. We evaluated the risk factors associated with complications after oncoplastic breast reduction. METHODS: A single-institution, institutional review board-approved, retrospective review of electronic medical records of female patients with breast cancer who underwent oncoplastic breast reduction from 2008 to 2014. A review of electronic medical records collected relevant medical history, clinical and pathological information, and data on postoperative complications within 6 months stratified into major or minor complications. Categorical variables analyzed with the χ2 exact method; continuous variables were analyzed with the Wilcoxon rank sum test exact method. RESULTS: We identified 59 patients; 4 required re-excision for positive margins, and 1 moved on to completion mastectomy. The overall complication rate was 33.9% (n = 20): 12 major (20.3%) and 8 minor (13.6%). Of the continuous variables (age, body mass index, and tissue removed), increased age was associated with minor complications (P = 0.02). Among the categorical variables (stratified body mass index, prior breast surgery, hypertension, diabetes mellitus, hyperlipidemia, vascular disease, pulmonary disease, and stratified weight of tissue removed), none were associated with overall or major complications. Pulmonary disease was associated with minor complications (P = 0.03). Bilateral versus unilateral oncoplastic breast reduction showed no statistically significant increase in complications. CONCLUSIONS: The overall complication rate after oncoplastic breast reduction was markedly higher than that in nationally published data for breast-conserving surgery. The complication rate resembled more closely the complication rate after bilateral mastectomy with immediate reconstruction. No risk factors were associated with major or overall complications. Age and pulmonary disease were associated with minor complications. Patients should be selected and counseled appropriately when considering oncoplastic breast reduction.
Authors: Judy C Boughey; Tina J Hieken; James W Jakub; Amy C Degnim; Clive S Grant; David R Farley; Kristine M Thomsen; John B Osborn; Gary L Keeney; Elizabeth B Habermann Journal: Surgery Date: 2014-03-18 Impact factor: 3.982
Authors: Elvira L Vos; Anton H J Koning; Inge-Marie Obdeijn; Victorien M T van Verschuer; Cornelis Verhoef; Peter J van der Spek; Marian B Menke-Pluijmers; Linetta B Koppert Journal: J Surg Oncol Date: 2014-10-20 Impact factor: 3.454
Authors: Alexandre Mendonça Munhoz; Cláudia Maria Aldrighi; Eduardo Montag; Eduardo Arruda; José Augusto Brasil; José Roberto Filassi; José Mendes Aldrighi; Rolf Gemperli; Marcus Castro Ferreira Journal: Ann Plast Surg Date: 2011-09 Impact factor: 1.539
Authors: Meena S Moran; Stuart J Schnitt; Armando E Giuliano; Jay R Harris; Seema A Khan; Janet Horton; Suzanne Klimberg; Mariana Chavez-MacGregor; Gary Freedman; Nehmat Houssami; Peggy L Johnson; Monica Morrow Journal: Int J Radiat Oncol Biol Phys Date: 2014-03-01 Impact factor: 7.038
Authors: Max H Haloua; Nicole M A Krekel; Henri A H Winters; Derek H F Rietveld; Sybren Meijer; Frank W Bloemers; Monique P van den Tol Journal: Ann Surg Date: 2013-04 Impact factor: 12.969
Authors: Bernard Fisher; Stewart Anderson; John Bryant; Richard G Margolese; Melvin Deutsch; Edwin R Fisher; Jong-Hyeon Jeong; Norman Wolmark Journal: N Engl J Med Date: 2002-10-17 Impact factor: 91.245
Authors: Alice Lee; Richard M Kwasnicki; Hasaan Khan; Yasmin Grant; Abigail Chan; Angela E E Fanshawe; Daniel R Leff Journal: BJS Open Date: 2021-11-09
Authors: Tasha A Martin; Salman Choudhry; Luther H Holton; W Charles Mylander; Lorraine Tafra; Wen Liang; Rubie Sue Jackson Journal: Plast Reconstr Surg Glob Open Date: 2022-09-23