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

Oscar J. Manrique, Ali Charafeddine, Amjed Abu-Ghname, Joseph Banuelos, Steven R. Jacobson, Jorys Martinez-Jorge, Minh Doan Nguyen, Christin Harless, Nho V. Tran, Basel Sharaf, James W Jakub, Tina J Hieken, Amy C Degnim, Judy C Boughey

Research output: Contribution to journalArticle

Abstract

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/m2. 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.

Original languageEnglish (US)
JournalMedicina (Kaunas, Lithuania)
Volume55
Issue number8
DOIs
StatePublished - Aug 14 2019

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Mammaplasty
Outcome Assessment (Health Care)
Radiation
Population
Breast
Mastectomy
Logistic Models
Equipment and Supplies
ROC Curve
Counseling
Anatomy
Obesity
Breast Neoplasms

Keywords

  • adjuvant radiation
  • implants-based breast reconstruction
  • obesity
  • reconstructive outcome
  • young females

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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.

In: Medicina (Kaunas, Lithuania), Vol. 55, No. 8, 14.08.2019.

Research output: Contribution to journalArticle

Manrique, OJ, Charafeddine, A, Abu-Ghname, A, Banuelos, J, Jacobson, SR, Martinez-Jorge, J, Nguyen, MD, Harless, C, Tran, NV, Sharaf, B, Jakub, JW, Hieken, TJ, Degnim, AC & Boughey, JC 2019, 'Two-Staged Implant-Based Breast Reconstruction: A Long-Term Outcome Study in a Young Population', Medicina (Kaunas, Lithuania), vol. 55, no. 8. https://doi.org/10.3390/medicina55080481
Manrique OJ, Charafeddine A, Abu-Ghname A, Banuelos J, Jacobson SR, Martinez-Jorge J et al. Two-Staged Implant-Based Breast Reconstruction: A Long-Term Outcome Study in a Young Population. Medicina (Kaunas, Lithuania). 2019 Aug 14;55(8). https://doi.org/10.3390/medicina55080481
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. In: Medicina (Kaunas, Lithuania). 2019 ; Vol. 55, No. 8.
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abstract = "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/m2. 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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AU - Manrique, Oscar J.

AU - Charafeddine, Ali

AU - Abu-Ghname, Amjed

AU - Banuelos, Joseph

AU - Jacobson, Steven R.

AU - Martinez-Jorge, Jorys

AU - Nguyen, Minh Doan

AU - Harless, Christin

AU - Tran, Nho V.

AU - Sharaf, Basel

AU - Jakub, James W

AU - Hieken, Tina J

AU - Degnim, Amy C

AU - Boughey, Judy C

PY - 2019/8/14

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N2 - 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/m2. 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.

AB - 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/m2. 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.

KW - adjuvant radiation

KW - implants-based breast reconstruction

KW - obesity

KW - reconstructive outcome

KW - young females

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