What are the possible complications of breast reconstruction?

Updated: Jul 29, 2021
  • Author: Mark F Deutsch, MD; Chief Editor: James Neal Long, MD, FACS  more...
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A retrospective study by Valente et al found that the risk of cancer recurrence was not increased among patients in whom, owing to wound complications subsequent to immediate postmastectomy breast reconstruction, initiation of adjuvant systemic breast cancer therapy was delayed. [18]

A literature review by Joo et al found that in patients with breast cancer who underwent skin- or nipple-sparing mastectomy and reconstruction, local recurrence most often arose in the skin and/or subcutaneous tissue. In skin- or nipple-sparing mastectomy patients who underwent autologous reconstruction, 1.8% experienced local recurrence in the skin/subcutaneous tissue; 0.7%, in the chest wall; and 0.4%, in the nipple-areolar complex. In those who underwent implant reconstruction, 4.7% suffered local recurrence that included the skin/subcutaneous tissue, 0.4% had recurrence in the chest wall, and 0.4% experienced recurrence in the nipple-areolar complex. [19]

In a study of abdominally based flaps, Kwok et al determined the return rate to the operating room for vascular anastomosis revision to be 0% following immediate unilateral breast reconstruction with pedicled TRAM flaps. In comparison, the rates were 1.72%, 2.66%, and 5.64% for free TRAM flaps, DIEP flaps, and superficial inferior epigastric artery perforator (SIEA) flaps, respectively. [20]

A retrospective study by Patel et al indicated that in patients who undergo flap-based salvage reconstruction in radiated breast tissue, latissimus dorsi flaps (plus implants) and abdominally based flaps (consisting of muscle-sparing TRAM or DIEP flaps) have similar postoperative complication rates. However, abdominal flaps were associated with a significantly higher rate of wound dehiscence. [21]

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