One-stage breast reconstruction techniques in elderly patients to preserve quality of life.
Eur Rev Med Pharmacol Sci
; 20(24): 5058-5066, 2016 12.
Article
in En
| MEDLINE
| ID: mdl-28051266
ABSTRACT
OBJECTIVE:
The aim of this study was to review one-stage breast reconstruction techniques performed in elderly patients at our institution to identify the criteria of selection of each in terms of outcomes and quality of life. PATIENTS ANDMETHODS:
Patients older than 65 years who underwent one-stage breast reconstruction between January 2004 and July 2014 at our hospital were included. Patients and procedure-related data were collected from the medical records. In particular, patient's age, comorbidities and related ASA physical status, type of one-stage breast reconstruction technique, and criteria of selection were analyzed. Outcomes and results were also evaluated in terms of quality of life using the EORTC QLQ-C30 and -BR23 questionnaires 1 year after surgery.RESULTS:
A total of 840 women underwent breast reconstruction, of whom 138 elderly women received one-stage breast reconstruction. There were 118 cases (85.5%) of monolateral reconstructions and 20 cases (14.5%) of bilateral reconstructions, resulting in 138 breast reconstructions. These were performed with permanent inflatable expanders in the sub-muscular position (Group A, n= 50), with acellular dermal matrix and partial sub-muscular anatomic implant (Group B, n= 50), and with Braxon® acellular dermal matrix and anatomic implant with muscle-sparing technique (Group C, n= 38). The EORTC questionnaires showed the best results in Group C regarding the quality of life.CONCLUSIONS:
The elderly population is rapidly increasing, and 50% of all breast cancers occur in women older than 65 years; among them, only 2% undergo breast reconstruction. A major aspect of breast cancer treatment and subsequent quality of life is the opportunity for a post-mastectomy reconstructive surgery. As survival rates are improving, a larger proportion of patients live with the long-term consequences of their treatment, and breast reconstruction ensures a better quality of life. To increase the reconstruction rates, surgery should be one-stage, less invasive as possible, allowing rapid recovery, especially in elderly women, in whom comorbidities are often present with a higher anaesthetic risk. Our study highlighted that non-skin sparing mastectomy (SSM) and delayed reconstructions should be addressed with Becker implants; immediate reconstructions after SSM should be followed by acellular dermal matrix (ADM)-assisted implant reconstruction, preferring the wrap technique offers a better quality of life in elderly patients.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Quality of Life
/
Breast Implants
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspects:
Patient_preference
Limits:
Aged
/
Female
/
Humans
Language:
En
Journal:
Eur Rev Med Pharmacol Sci
Journal subject:
FARMACOLOGIA
/
TOXICOLOGIA
Year:
2016
Document type:
Article
Affiliation country: