Surgical complications after immediate implant-based breast reconstruction for breast cancer in women over 65 years.

IF 3.5 3区医学 Q1 SURGERY

BJS Open Pub Date : 2024-09-03 DOI:10.1093/bjsopen/zrae095

Yihang Liu, Anna L V Johansson, Ira Oikonomou, Axel Frisell, Hannah C Adam, Dhirar Ansarei, Martin Halle, Helena Sackey, Jana de Boniface

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Abstract

Background: While immediate breast reconstruction rates in breast cancer are increasing, they remain low in women over 65 years old. The aim was to investigate surgical outcomes in women older than 65 years receiving implant-based immediate breast reconstruction.

Method: The population-based Stockholm Breast Reconstruction Database includes all adult women with breast cancer receiving an implant-based immediate breast reconstruction in Stockholm, Sweden, 2005-2015. Primary outcomes within 30 days from immediate breast reconstruction were: infection requiring antibiotics and reoperation on. Implant removal was a secondary outcome. Women more than 65 years were compared with younger age groups. Chi-square tests and multivariable logistic regression were applied for the primary outcomes, and Kaplan-Meier analysis for the secondary outcome.

Results: Among 1749 cases of immediate breast reconstruction, 140 (8.0%) were in women more than 65 years. Median follow-up was 74 months (1-198). Postoperative infection was not more common in women older than 65 years old (22 of 140, 15.7%) than in women under 65 years old (303 of 1609, 18.8%; P = 0.221). Reoperation on was more frequent in women older than 65 years than in other age groups (more than 65: 8.6%; 50-64: 6.5%; 40-49: 3.5%; less than 40: 1.6%; P < 0.001), however, age older than 65 years was not an independent risk factor in the multivariable analysis (OR 1.00, 95% c.i. 0.44 to 2.28). Overall, 6-year probability of implant removal was 11.4%, (8.1% due to complications and 3.3% due to patient preference). There was no statistically significant difference between age groups for either reason (P = 0.085 and P = 0.794 respectively).

Conclusion: Older age alone was not associated with worse surgical outcomes after implant-based immediate breast reconstruction in highly selected patients older than 65 years when compared with their younger counterparts.

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65 岁以上女性因乳腺癌接受假体乳房即刻重建术后的手术并发症。

背景：虽然乳腺癌患者的即刻乳房重建率在不断上升，但 65 岁以上女性的即刻乳房重建率仍然很低。本研究旨在调查 65 岁以上女性接受植入式即刻乳房重建的手术效果：基于人群的斯德哥尔摩乳房重建数据库包括2005-2015年在瑞典斯德哥尔摩接受植入式即刻乳房重建的所有乳腺癌成年女性。乳房即刻重建术后 30 天内的主要结果是：感染，需要使用抗生素和再次手术。植入物取出是次要结果。65岁以上女性与年轻女性进行了比较。对主要结果进行了卡普兰-梅耶分析，对次要结果进行了卡普兰-梅耶分析：在1749例即刻乳房再造手术中，有140例（8.0%）是65岁以上的女性。中位随访时间为 74 个月（1-198）。65 岁以上女性术后感染的发生率（140 例中有 22 例，占 15.7%）并不高于 65 岁以下女性（1609 例中有 303 例，占 18.8%；P = 0.221）。与其他年龄组相比（65 岁以上：8.6%；50-64 岁：6.5%；40-49 岁：3.5%；40 岁以下：1.6%；P <0.001），65 岁以上的妇女再次手术的频率更高，但在多变量分析中，年龄超过 65 岁并不是一个独立的风险因素（OR 1.00，95% 置信区间：0.44 至 2.28）。总体而言，6 年内移除种植体的概率为 11.4%（8.1% 由于并发症，3.3% 由于患者偏好）。无论哪种原因，不同年龄组之间的差异均无统计学意义（分别为 P = 0.085 和 P = 0.794）：结论：对于经过严格筛选的 65 岁以上患者，与年轻患者相比，年龄越大，假体即刻乳房重建的手术效果越差。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BJS Open SURGERY-

CiteScore

6.00

自引率

3.20%

发文量

144