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. 1993 Jul;218(1):29–36. doi: 10.1097/00000658-199307000-00006

Prospective evaluation of immediate reconstruction after mastectomy.

T J Eberlein 1, L D Crespo 1, B L Smith 1, C A Hergrueter 1, L Douville 1, E Eriksson 1
PMCID: PMC1242897  PMID: 8328826

Abstract

OBJECTIVE: The authors prospectively studied the impact of immediate breast reconstruction on patients undergoing mastectomy. SUMMARY BACKGROUND DATA: Despite the advocation of a breast-conserving approach to the treatment of breast cancer, many women continue to medically require or choose mastectomy for the treatment of breast cancer. In recent years, immediate breast reconstruction has become an alternative to either mastectomy alone or to delayed reconstruction. METHODS: A prospective database of 216 patients who underwent mastectomy with immediate reconstruction was established. In this series, 94 procedures involved implants or tissue expanders, and 124 tissue transfers were performed. RESULTS: The overall complication rate was 15.3%; only 9% of patients who underwent autologous tissue transfers required secondary procedures. When implants were performed, the overall rate of prosthetic loss was 8%. The majority of patients (n = 101) underwent transverse rectus abdominis musculocutaneous (TRAM) flaps. Twenty-six of the 38 (17.5%) patients who required transfusion were from this group. Partial flap losses in this group (7%) were correlated to a history of heavy smoking. With a median follow-up of 33.2 months, only two patients had recurred locally. According to patient opinion, autologous tissue transfers resulted in a statistically better cosmetic result. CONCLUSIONS: Immediate reconstruction can be performed safely and with excellent cosmetic results.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Boring C. C., Squires T. S., Tong T. Cancer statistics, 1991. CA Cancer J Clin. 1991 Jan-Feb;41(1):19–36. doi: 10.3322/canjclin.41.1.19. [DOI] [PubMed] [Google Scholar]
  2. Bostwick J., 3rd, Vasconez L. O., Jurkiewicz M. J. Breast reconstruction after a radical mastectomy. Plast Reconstr Surg. 1978 May;61(5):682–693. doi: 10.1097/00006534-197805000-00004. [DOI] [PubMed] [Google Scholar]
  3. Dowden R. V. Selection criteria for successful immediate breast reconstruction. Plast Reconstr Surg. 1991 Oct;88(4):628–634. doi: 10.1097/00006534-199110000-00011. [DOI] [PubMed] [Google Scholar]
  4. Frazier T. G., Noone R. B. An objective analysis of immediate simultaneous reconstruction in the treatment of primary carcinoma of the breast. Cancer. 1985 Mar 15;55(6):1202–1205. doi: 10.1002/1097-0142(19850315)55:6<1202::aid-cncr2820550611>3.0.co;2-t. [DOI] [PubMed] [Google Scholar]
  5. Georgiade G. S., Georgiade N. G., McCarty K. S., Jr, Ferguson B. J., Seigler H. F. Modified radical mastectomy with immediate reconstruction for carcinoma of the breast. Ann Surg. 1981 May;193(5):565–573. doi: 10.1097/00000658-198105000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Georgiade G., Georgiade N., McCarty K. S., Jr, Seigler H. F. Rationale for immediate reconstruction of the breast following modified radical mastectomy. Ann Plast Surg. 1982 Jan;8(1):20–28. doi: 10.1097/00000637-198201000-00006. [DOI] [PubMed] [Google Scholar]
  7. Grotting J. C., Urist M. M., Maddox W. A., Vasconez L. O. Conventional TRAM flap versus free microsurgical TRAM flap for immediate breast reconstruction. Plast Reconstr Surg. 1989 May;83(5):828–844. doi: 10.1097/00006534-198905000-00009. [DOI] [PubMed] [Google Scholar]
  8. Hartrampf C. R., Jr, Bennett G. K. Autogenous tissue reconstruction in the mastectomy patient. A critical review of 300 patients. Ann Surg. 1987 May;205(5):508–519. doi: 10.1097/00000658-198705000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Mansel R. E., Horgan K., Webster D. J., Shrotria S., Hughes L. E. Cosmetic results of immediate breast reconstruction post-mastectomy: a follow-up study. Br J Surg. 1986 Oct;73(10):813–816. doi: 10.1002/bjs.1800731018. [DOI] [PubMed] [Google Scholar]
  10. McCraw J. B., Horton C. E., Grossman J. A., Kaplan I., McMellin A. An early appraisal of the methods of tissue expansion and the transverse rectus abdominis musculocutaneous flap in reconstruction of the breast following mastectomy. Ann Plast Surg. 1987 Feb;18(2):93–113. doi: 10.1097/00000637-198702000-00003. [DOI] [PubMed] [Google Scholar]
  11. McCraw J. B., Horton C. E., Grossman J. A., Kaplan I., McMellin A. An early appraisal of the methods of tissue expansion and the transverse rectus abdominis musculocutaneous flap in reconstruction of the breast following mastectomy. Ann Plast Surg. 1987 Feb;18(2):93–113. doi: 10.1097/00000637-198702000-00003. [DOI] [PubMed] [Google Scholar]
  12. Noone R. B., Murphy J. B., Spear S. L., Little J. W., 3rd A 6-year experience with immediate reconstruction after mastectomy for cancer. Plast Reconstr Surg. 1985 Aug;76(2):258–269. doi: 10.1097/00006534-198508000-00012. [DOI] [PubMed] [Google Scholar]
  13. Patey D. H. A review of 146 cases of carcinoma of the breast operated on between 1930 and 1943. Br J Cancer. 1967 Jun;21(2):260–269. doi: 10.1038/bjc.1967.28. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Russell I. S., Collins J. P., Holmes A. D., Smith J. A. The use of tissue expansion for immediate breast reconstruction after mastectomy. Med J Aust. 1990 Jun 18;152(12):632–635. doi: 10.5694/j.1326-5377.1990.tb125418.x. [DOI] [PubMed] [Google Scholar]
  15. Stevens L. A., McGrath M. H., Druss R. G., Kister S. J., Gump F. E., Forde K. A. The psychological impact of immediate breast reconstruction for women with early breast cancer. Plast Reconstr Surg. 1984 Apr;73(4):619–628. doi: 10.1097/00006534-198404000-00018. [DOI] [PubMed] [Google Scholar]
  16. Vinton A. L., Traverso L. W., Zehring R. D. Immediate breast reconstruction following mastectomy is as safe as mastectomy alone. Arch Surg. 1990 Oct;125(10):1303–1308. doi: 10.1001/archsurg.1990.01410220087012. [DOI] [PubMed] [Google Scholar]
  17. Wellisch D. K., Schain W. S., Noone R. B., Little J. W., 3rd Psychosocial correlates of immediate versus delayed reconstruction of the breast. Plast Reconstr Surg. 1985 Nov;76(5):713–718. doi: 10.1097/00006534-198511000-00010. [DOI] [PubMed] [Google Scholar]

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