Complications after immediate breast reconstruction in primary versus completion mastectomy following breast-conserving therapy
Caroline Korduner, Arvin Mokhtari, Looket DihgeAbstract
Introduction
Primary mastectomy with immediate breast reconstruction (IBR) is increasingly performed, with described outcomes and complication profiles. In contrast, postoperative outcomes after completion mastectomy with IBR following breast-conserving therapy (BCT) for positive margins remain limited. This study compared early and delayed postoperative complications after mastectomy with IBR in patients with and without prior BCT.
Methods
A total of 107 patients with clinically node-negative breast cancer were included. Patients were treated at Skåne University Hospital in Malmö between 2014 and 2020 and underwent either primary mastectomy with IBR (n = 63) or initial BCT followed by completion mastectomy with IBR due to positive margins (n = 44). Baseline patient characteristics, reconstruction method, and postoperative outcomes were obtained from medical records. Early postoperative complications (<30 days) included haemorrhage, seroma formation, and surgical site infection. Delayed complications (≤1 year) were evaluated.
Results
Age, BMI and tumour size were comparable in the two groups. Implant-based reconstruction was more commonly performed than autologous reconstruction in both groups and was more frequent after primary mastectomy than after completion mastectomy (91 versus 74%). Completion mastectomy with IBR after prior BCT was associated with higher rates of postoperative haemorrhage (11 versus 8%) and seroma formation (9 versus 5%). Delayed complication rates were similar between the groups.
Discussion
Completion mastectomy with IBR after prior BCT demonstrated higher rates of haemorrhage and seroma formation within 30 days postoperatively than primary mastectomy with IBR. These findings warrant further evaluation in larger cohorts.