Is Immediate Breast Reconstruction an Option for Elderly Women? A Comparative Study Between Elderly and Younger Population.

Objective: To evaluate the incidence of postoperative complications (POC) in elderly patients (EP) compared to younger patients (YP) following immediate breast reconstruction (IBR) after total mastectomy (TM).

Methods: This retrospective study included patients treated at the Institut Universitaire of Cancer of Toulouse-Oncopole (IUCT-O) between January 2014 and May 2022. The primary outcome was the incidence of POC within 30 days postoperatively. Secondary outcomes included the delay before initiation of adjuvant treatments and re-hospitalization rates.

Results: Elderly patients had a significantly higher rate of POC compared to younger patients, affecting 27.9% of EP and only 14.8% of YP. However, the severity of complications does not differ significantly between YP and EP (69.1% of major POC for YP and 64.7% for EP, P = .6680). Rates of re-hospitalization within 30 days between the 2 groups are similar (67.3% for YP and 61.8% for EP, P = .5962). Most importantly, these complications are not responsible for a delay in initiating adjuvant treatment compared with the younger population. Age ≥ 70 years and obesity (BMI ≥ 30) were identified as independent risk factors for POC.

Conclusion: Despite a higher rate of POC, immediate breast reconstruction can be considered for elderly patients, but these patients should be carefully selected and assessed preoperatively to limit the risk of POC.