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Introduction. Mastectomy continues to be the proper and necessary treatment in some cases of breast cancer. Breast reconstruction is no longer an occasional surgical intervention; currently, there is a constant and growing demand on the part of mastectomy patients. The objective of this report is to analyze the morbidity, mortality and cosmetic results associated with postmastectomy breast reconstruction using prosthetic implants. The degree of satisfaction of patients and the surgical team are also assessed.
Patients and methods. The study focused on 37 consecutive patients who underwent 41 breast reconstruction (BR) procedures to implant prostheses in a General Surgery service between May 1992 and December 1996. The Becker expander implant was utilized on 38 occasions. Fourteen BR procedures were performed immediately after mastectomy and 27 were delayed until later on. Immediate BR with prosthesis was carried out only in those patients who had not undergone axillary lymphadenectomy.
Results. There were no deaths in the series. Prosthesis-related morbidity (n = 3; 7.3%) consisted of 2 cases of extrusion due to infection and one case of late intolerance that required replacement of the implant. All the complications occurred in patients who had undergone immediate BR.
The degree of satisfaction of the patients surveyed, in range of 0 to 5 points, was as follows: 0 points, 2 patients; 1 point, 2 patients; 2 points, no patients; 3 points, 1 patient; 4 points, 6 patients; and 5 points, 20 patients; average score: 4.1.
The surgical team showed the following degree of satisfaction: 0 points, 2; 1 point, 1; 2 points, 4; 3 points, 9; 4 points, 9; and 5 points, 6; average score: 3.3.
Conclusions.. Delayed BR with prosthesis implantation is a simple and safe technique, given the low morbidity rate and nonexistent mortality of our series, although in most cases, a second, more complex operation is necessary to symme trize the healthy breast. The rate of morbidity associated with immediate BR is markedly higher than that seen in delayed BR. The degree of satisfaction of patients who un dergo postmastectomy BR is elevated, in most cases, more so than that of the surgical team. We consider that the practice of BR can and should be assumed by trained, motivated surgeons.
Patients and methods. The study focused on 37 consecutive patients who underwent 41 breast reconstruction (BR) procedures to implant prostheses in a General Surgery service between May 1992 and December 1996. The Becker expander implant was utilized on 38 occasions. Fourteen BR procedures were performed immediately after mastectomy and 27 were delayed until later on. Immediate BR with prosthesis was carried out only in those patients who had not undergone axillary lymphadenectomy.
Results. There were no deaths in the series. Prosthesis-related morbidity (n = 3; 7.3%) consisted of 2 cases of extrusion due to infection and one case of late intolerance that required replacement of the implant. All the complications occurred in patients who had undergone immediate BR.
The degree of satisfaction of the patients surveyed, in range of 0 to 5 points, was as follows: 0 points, 2 patients; 1 point, 2 patients; 2 points, no patients; 3 points, 1 patient; 4 points, 6 patients; and 5 points, 20 patients; average score: 4.1.
The surgical team showed the following degree of satisfaction: 0 points, 2; 1 point, 1; 2 points, 4; 3 points, 9; 4 points, 9; and 5 points, 6; average score: 3.3.
Conclusions.. Delayed BR with prosthesis implantation is a simple and safe technique, given the low morbidity rate and nonexistent mortality of our series, although in most cases, a second, more complex operation is necessary to symme trize the healthy breast. The rate of morbidity associated with immediate BR is markedly higher than that seen in delayed BR. The degree of satisfaction of patients who un dergo postmastectomy BR is elevated, in most cases, more so than that of the surgical team. We consider that the practice of BR can and should be assumed by trained, motivated surgeons.
Keywords:
Breast cancer
Mastectomy
Breast reconstruction
Prosthesis
