Background: Mastectomy is an optional surgical management of breast cancer, but it can cause significant adverse reactions. Breast reconstruction is a concern in post-mastectomy recovery. We assessed the oncologic safety and patient satisfaction following immediate breast reconstruction using an implant or tissue expander.
Methods: We retrospectively reviewed all patients who underwent reconstruction with an implant or tissue expander immediately after mastectomy. Seventy-seven patients underwent breast reconstruction at a general hospital breast cancer center from January 2008 to December 2010. Fourteen patients were excluded due to loss at follow-up, so 63 patients were included in this study. Questionnaires were sent to all patients to assess patient satisfaction.
Results: Mean age was 44.1 years (range 29-64). After a median follow-up period of 22.4 months, there was 1 case of locoregional recurrence, 1 case of distant metastasis, and an overall breast cancer-specific survival of 100 %. Overall rate of major complications, such as nipple areolar complex (NAC) necrosis and implant removal, was 11.1 % (7 patients). Of the 10 patients who had NAC necrosis, 6 patients improved after observation and 4 patients had NAC excision. Three patients had their implant removed due to severe infection, leakage, and dissatisfaction, respectively. There were 32 cases of total mastectomy (TM), 12 cases of skin-sparing mastectomy (SSM), and 19 cases of NAC-sparing mastectomy (NSM). According to the questionnaire, 84.1 % were satisfied with the general operational result and 77.8 % with the cosmetic result. Of the 31 patients who received conservative surgery, 87.1 % were satisfied with the general result and 83.9 % with the cosmetic result.
Conclusions: Immediate breast reconstruction using an implant after mastectomy was technically feasible and oncologically safe. In addition, the reconstruction resulted in a relatively high rate of patient satisfaction. Further long-term studies are warranted to confirm these findings.
Keywords: Breast cancer; Immediate breast reconstruction; Implant; Mastectomy; Tissue expander.