Change in Body Mass Index After Breast Reconstruction and Associated Complications

Objective: The incidence and prevalence of breast cancer continue to rise. Therapies may contribute to patient weight gain. Obesity, a major predictor of surgical complications, may affect reconstructive outcome. The goal of this study was to quantify weight gain/change after the diagnosis and treatment of breast cancer in women choosing reconstruction after mastectomy. Methods: Retrospective review of patients undergoing mastectomy with reconstruction at a dedicated Cancer Center from 1996 to 2011 was conducted. Patient demographics, body mass index (BMI), and surgical complications were reported. Patients were stratified as normal weight (BMI <25 kg/m(2)) and overweight/obese (BMI >25 kg/m(2)). Body mass index at the time of mastectomy was compared with BMI postreconstruction. Results: A total of 443 patients had mastectomy and reconstruction. Forty-nine percent of patients were classified as normal weight (BMI <25 kg/m(2)) at the time of mastectomy and 51% as overweight/obese (body mass index > 25 kg/m(2)). Mean body mass index at the time of mastectomy was 26.1 kg/m(2) (4.9 SD) and 26.4 kg/m(2) (5.1 SD) at the final follow-up. Median follow-up time was 2.7 years (range <1 to 15 years). There was no statistically significant change in BMI before and after cancer treatment (P > .05). However, overweight/obese patients with complications were more likely to require an unanticipated return to the operating room (P = .0124). Conclusions: Despite the stress of breast cancer diagnosis, surgical treatment, and reconstruction, we find that patients' weight does not change significantly over time. Overweight and obese patients are not always at higher risk for surgical complications but may have more severe complications when they do occur.