TY - JOUR
T1 - Immediate breast reconstruction in the elderly
T2 - can it be considered an integral step of breast cancer treatment? The experience of the European Institute of Oncology, Milan
AU - De Lorenzi, Francesca
AU - Rietjens, Mario
AU - Soresina, Massimo
AU - Rossetto, Fabio
AU - Bosco, Riccardo
AU - Vento, Anna Rita
AU - Monti, Simonetta
AU - Petit, Jean Y.
PY - 2010/3
Y1 - 2010/3
N2 - 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.
AB - 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.
KW - Breast reconstruction
KW - Elderly
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U2 - 10.1016/j.bjps.2008.11.054
DO - 10.1016/j.bjps.2008.11.054
M3 - Article
C2 - 19110479
AN - SCOPUS:75149166721
VL - 63
SP - 511
EP - 515
JO - Journal of Plastic, Reconstructive and Aesthetic Surgery
JF - Journal of Plastic, Reconstructive and Aesthetic Surgery
SN - 1748-6815
IS - 3
ER -