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

Research output: Contribution to journalArticle

20 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)511-515
Number of pages5
JournalJournal of Plastic, Reconstructive and Aesthetic Surgery
Volume63
Issue number3
DOIs
Publication statusPublished - Mar 2010

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Mammaplasty
Breast Neoplasms
Therapeutics
Breast
Mastectomy
Contracture
Subcutaneous Mastectomy
Simple Mastectomy
Radical Mastectomy
Modified Radical Mastectomy
Rectus Abdominis
Superficial Back Muscles
Segmental Mastectomy
Nipples
Silicones
Infection
Postoperative Period
Population
Prostheses and Implants
Necrosis

Keywords

  • Breast reconstruction
  • Elderly

ASJC Scopus subject areas

  • Surgery

Cite this

@article{b59331792f1d48aea05a9eb680efa6b5,
title = "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",
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.",
keywords = "Breast reconstruction, Elderly",
author = "{De Lorenzi}, Francesca and Mario Rietjens and Massimo Soresina and Fabio Rossetto and Riccardo Bosco and Vento, {Anna Rita} and Simonetta Monti and Petit, {Jean Y.}",
year = "2010",
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doi = "10.1016/j.bjps.2008.11.054",
language = "English",
volume = "63",
pages = "511--515",
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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.

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SN - 1748-6815

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