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Two-Staged Implant-Based Breast Reconstruction: A Long-Term Outcome Study in a Young Population

Background and objectives: Differences in patient anatomy and physiology exist between young and older patients undergoing breast reconstruction after mastectomy. Breast cancer has been described as being more aggressive, more likely to receive radiation, contralateral mastectomy, as well as bilater...

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Autores principales: Manrique, Oscar J., Charafeddine, Ali, Abu-Ghname, Amjed, Banuelos, Joseph, Jacobson, Steven R., Martinez-Jorge, Jorys, Nguyen, Minh-Doan, Harless, Christin, Tran, Nho V., Sharaf, Basel, Jakub, James W., Hieken, Tina J., Degnim, Amy C., Boughey, Judy C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723805/
https://www.ncbi.nlm.nih.gov/pubmed/31416221
http://dx.doi.org/10.3390/medicina55080481
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author Manrique, Oscar J.
Charafeddine, Ali
Abu-Ghname, Amjed
Banuelos, Joseph
Jacobson, Steven R.
Martinez-Jorge, Jorys
Nguyen, Minh-Doan
Harless, Christin
Tran, Nho V.
Sharaf, Basel
Jakub, James W.
Hieken, Tina J.
Degnim, Amy C.
Boughey, Judy C.
author_facet Manrique, Oscar J.
Charafeddine, Ali
Abu-Ghname, Amjed
Banuelos, Joseph
Jacobson, Steven R.
Martinez-Jorge, Jorys
Nguyen, Minh-Doan
Harless, Christin
Tran, Nho V.
Sharaf, Basel
Jakub, James W.
Hieken, Tina J.
Degnim, Amy C.
Boughey, Judy C.
author_sort Manrique, Oscar J.
collection PubMed
description Background and objectives: Differences in patient anatomy and physiology exist between young and older patients undergoing breast reconstruction after mastectomy. Breast cancer has been described as being more aggressive, more likely to receive radiation, contralateral mastectomy, as well as bilateral reconstruction in young patients. Our purpose is to report long-term experience on two-staged implant-based breast reconstruction (IBR) in young females, with complication sub-analysis based on obesity and adjuvant radiation. Materials and Methods: Retrospective chart review of all consecutive young patients who underwent two-staged IBR at our institution, between 2000 and 2016, was performed. Patients between 15 and 40 years old with least 1-year follow-up were included. Univariate logistic regression models and receiver operating characteristic (ROC) curves were created. Results: Overall 594 breasts met our inclusion criteria. The mean age was 34 years, and the median follow-up was 29.6 months. Final IBR was achieved in 98% of breasts. Overall, 12% of breasts had complications, leading to explantations of 5% of the devices. Adjuvant radiation was followed by higher rates of total device explantations (p = 0.003), while obese patients had higher rates of total complications (p < 0.001). For each point increase in BMI, the odds of developing complications increased 8.1% (p < 0.001); the cutoff BMI to predict higher complications was 24.81 kg/m(2). Conclusions: This population demonstrates high successful IBR completion and low explantation rates. These data suggest that obese women and those with planned adjuvant radiation deserve special counseling about their higher risk of complications.
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spelling pubmed-67238052019-09-10 Two-Staged Implant-Based Breast Reconstruction: A Long-Term Outcome Study in a Young Population Manrique, Oscar J. Charafeddine, Ali Abu-Ghname, Amjed Banuelos, Joseph Jacobson, Steven R. Martinez-Jorge, Jorys Nguyen, Minh-Doan Harless, Christin Tran, Nho V. Sharaf, Basel Jakub, James W. Hieken, Tina J. Degnim, Amy C. Boughey, Judy C. Medicina (Kaunas) Article Background and objectives: Differences in patient anatomy and physiology exist between young and older patients undergoing breast reconstruction after mastectomy. Breast cancer has been described as being more aggressive, more likely to receive radiation, contralateral mastectomy, as well as bilateral reconstruction in young patients. Our purpose is to report long-term experience on two-staged implant-based breast reconstruction (IBR) in young females, with complication sub-analysis based on obesity and adjuvant radiation. Materials and Methods: Retrospective chart review of all consecutive young patients who underwent two-staged IBR at our institution, between 2000 and 2016, was performed. Patients between 15 and 40 years old with least 1-year follow-up were included. Univariate logistic regression models and receiver operating characteristic (ROC) curves were created. Results: Overall 594 breasts met our inclusion criteria. The mean age was 34 years, and the median follow-up was 29.6 months. Final IBR was achieved in 98% of breasts. Overall, 12% of breasts had complications, leading to explantations of 5% of the devices. Adjuvant radiation was followed by higher rates of total device explantations (p = 0.003), while obese patients had higher rates of total complications (p < 0.001). For each point increase in BMI, the odds of developing complications increased 8.1% (p < 0.001); the cutoff BMI to predict higher complications was 24.81 kg/m(2). Conclusions: This population demonstrates high successful IBR completion and low explantation rates. These data suggest that obese women and those with planned adjuvant radiation deserve special counseling about their higher risk of complications. MDPI 2019-08-14 /pmc/articles/PMC6723805/ /pubmed/31416221 http://dx.doi.org/10.3390/medicina55080481 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Manrique, Oscar J.
Charafeddine, Ali
Abu-Ghname, Amjed
Banuelos, Joseph
Jacobson, Steven R.
Martinez-Jorge, Jorys
Nguyen, Minh-Doan
Harless, Christin
Tran, Nho V.
Sharaf, Basel
Jakub, James W.
Hieken, Tina J.
Degnim, Amy C.
Boughey, Judy C.
Two-Staged Implant-Based Breast Reconstruction: A Long-Term Outcome Study in a Young Population
title Two-Staged Implant-Based Breast Reconstruction: A Long-Term Outcome Study in a Young Population
title_full Two-Staged Implant-Based Breast Reconstruction: A Long-Term Outcome Study in a Young Population
title_fullStr Two-Staged Implant-Based Breast Reconstruction: A Long-Term Outcome Study in a Young Population
title_full_unstemmed Two-Staged Implant-Based Breast Reconstruction: A Long-Term Outcome Study in a Young Population
title_short Two-Staged Implant-Based Breast Reconstruction: A Long-Term Outcome Study in a Young Population
title_sort two-staged implant-based breast reconstruction: a long-term outcome study in a young population
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723805/
https://www.ncbi.nlm.nih.gov/pubmed/31416221
http://dx.doi.org/10.3390/medicina55080481
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