A 35-Year Evolution of Free Flap-Based Breast Reconstruction at a Large Urban Academic Center.
J Reconstr Microsurg
; 32(2): 147-52, 2016 Feb.
Article
en En
| MEDLINE
| ID: mdl-26382872
ABSTRACT
BACKGROUND:
This study aims to characterize the evolution and trends in free flap breast reconstruction at our institution.METHODS:
The authors reviewed and analyzed a registry of free flap breast reconstructions performed at a large urban academic center.RESULTS:
Between 1979 and mid-2014, a total of 920 patients underwent breast reconstruction with 1,254 flaps. The mean age was 47.7 years (range, 16-79 years). Over the past 10 years, patients were older than all patients seen in the prior decade (average age 48.9 vs. 46.1 years, p = 0.002). Overall, 82% of flaps were performed at our university hospital, 17% at a major urban county hospital, and < 1% at other sites. A total of 99% patients received postmastectomy reconstruction for an existing cancer diagnosis or prophylaxis. There has been a significant increase in reconstructions, with 579 flaps performed over the past 5 years alone. There has been a fundamental shift in the predominant flap of choice over time. Perforator flaps have increased in popularity at our institution, with 74% of all reconstructions over this past 5 years being perforator based. Perforator flaps were more likely to be chosen over nonperforator flaps in older versus younger patients (p = 0.0008). There has been a steady increase in bilateral reconstructions since the first one was performed in 1987 (p = 0.002).CONCLUSIONS:
Over the past 35 years, our institution has seen a significant evolution in free flap-based breast reconstruction. Besides a massive increase in flap numbers we have seen a significant trend toward bilateral reconstructions and perforator-based flaps.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
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Neoplasias de la Mama
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Mamoplastia
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Servicios Urbanos de Salud
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Tiempo de Internación
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Mastectomía
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
J Reconstr Microsurg
Asunto de la revista:
NEUROCIRURGIA
Año:
2016
Tipo del documento:
Article