Cemile Nurdan Ozturk1, Can Ozturk2, Allison Soucise2, Nabiha Ahsan3, Joseph Kuhn4, Mary Platek5, Robert Lohman2, Wong Moon2, Raffi Gurunian6. 1. Roswell Park Comprehensive Cancer Center, Department of Head, Neck & Plastic Surgery, Elm & Carlton Streets, Buffalo, NY 14263, United States. Electronic address: cemile.ozturk@roswellpark.org. 2. Roswell Park Comprehensive Cancer Center, Department of Head, Neck & Plastic Surgery, Elm & Carlton Streets, Buffalo, NY 14263, United States. 3. State University of New York, Jacob's School of Medicine, Buffalo, NY, United States. 4. Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, United States. 5. D'Youville College, Buffalo, NY, United States. 6. Cleveland Clinic, Cleveland, OH, United States.
Abstract
INTRODUCTION: Contralateral prophylactic mastectomy has the potential to decrease the occurrence of cancer and reduce psychological burden. However, it is known that complications after bilateral mastectomy are higher compared with unilateral mastectomy. Our goal was to evaluate outcomes of immediate breast reconstruction in patients undergoing bilateral mastectomy and to compare complication rates between therapeutic and prophylactic sides. PATIENTS AND METHODS: Electronic medical records of patients with unilateral breast cancer who underwent bilateral mastectomy and immediate reconstruction with expanders were reviewed. Postoperative complications were compared between therapeutic and prophylactic mastectomy sides. RESULTS: Sixty-two patients were analyzed. The overall complication rate after both stages was 23.9% on the therapeutic side and 16.5% on the prophylactic side. Infection was the most common complication on both sides. All infections on the prophylactic mastectomy side were successfully treated with intravenous (IV) antibiotics (salvage rate of 100%), whereas 35.7% of infected tissue expander/implants on the therapeutic mastectomy side were explanted despite treatment. CONCLUSION: Careful counselling of patients undergoing elective contralateral prophylactic mastectomy is essential as complications can develop in either breast after reconstruction.
INTRODUCTION: Contralateral prophylactic mastectomy has the potential to decrease the occurrence of cancer and reduce psychological burden. However, it is known that complications after bilateral mastectomy are higher compared with unilateral mastectomy. Our goal was to evaluate outcomes of immediate breast reconstruction in patients undergoing bilateral mastectomy and to compare complication rates between therapeutic and prophylactic sides. PATIENTS AND METHODS: Electronic medical records of patients with unilateral breast cancer who underwent bilateral mastectomy and immediate reconstruction with expanders were reviewed. Postoperative complications were compared between therapeutic and prophylactic mastectomy sides. RESULTS: Sixty-two patients were analyzed. The overall complication rate after both stages was 23.9% on the therapeutic side and 16.5% on the prophylactic side. Infection was the most common complication on both sides. All infections on the prophylactic mastectomy side were successfully treated with intravenous (IV) antibiotics (salvage rate of 100%), whereas 35.7% of infected tissue expander/implants on the therapeutic mastectomy side were explanted despite treatment. CONCLUSION: Careful counselling of patients undergoing elective contralateral prophylactic mastectomy is essential as complications can develop in either breast after reconstruction.