Is immediate breast reconstruction surgery safe for elderly women? Assessment of postoperative complications in women aged 70 years and older

Abstract

Introduction

The rate of immediate breast reconstruction (IBR) in elderly women (EW) is lower than in younger patients because of concerns related to postoperative complications (POC) and their consequences.

Objective

We assessed POC 30 days after IBR, readmissions rate within 30 days, and the time to start adjuvant therapy in EW aged ≥ 70 years.

Materials and Methods

We conducted an observational, retrospective, single-center study between January 2014 and May 2022 at the University Cancer Institute of Toulouse-Oncopole (IUCT-O), including patients over 70 years old treated with mastectomy and IBR. Patients’ characteristics, medical treatments with the time between therapies and POC were recorded.

Results

A total of 125 women aged 70 to 84 years old were included in our study. The rate of IBR was 13.7 %. The rate of major POC was 17.6 % (n = 22), including 9.8 % (n = 11) implant removal. There was significantly more skin necrosis in patients with a history of homolateral radiotherapy (p = 0.016) but less hematoma (p = 0.004). Overweight or obese EW tending to have more than one surgical POC (p = 0.019). EW with nipple-areola complex (NAC) conservation had significantly more skin necrosis (p = 0.01). The median time for initiation of adjuvant chemotherapy (ACT) and hormonal therapy was 5.7 [1.6–11.9] and 4.3 [1.6–78.9] weeks respectively. The median time to initiate adjuvant radiotherapy (ART) when preceded by ACT or not, was 9.2 [5.1–22] and 21.1 [16.9–21.4] weeks respectively.

Conclusion

Our study confirms that IBR in women aged ≥ 70 years is safe and does not delay adjuvant therapies.