Kamali Parisa, Curiel Daniel, van Veldhuisen Charlotte L, Bucknor Alexandra E M, Lee Bernard T, Rakhorst Hinne A, Lin Samuel J
Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Division of Plastic- Reconstructive and Hand Surgery, Medisch Spectrum Twente, Enschede, The Netherlands.
J Surg Oncol. 2017 Jun;115(7):870-877. doi: 10.1002/jso.24595. Epub 2017 Apr 13.
Although approximately 57% of breast cancer (BC) diagnoses are in older patients (>60 years), only 4.1-14% receives breast reconstruction (BR). This has been attributed to physician concerns about operative complications. This paper aims to: 1) analyze the 30-day complication rates in the older patient population undergoing immediate breast reconstruction (IBR); and 2) analyze links between complication type and category of reconstruction.
Using the ACS-NSQIP database (2005-2014), all women older than 60 years of age diagnosed with BC and DCIS were identified. IBR and complication rates were plotted for all ages. Patients were divided into those with and those without complications. Patient demographics and co-morbidities were compared. Complications within each type of reconstruction were analyzed.
Of the 4450 BC and 1104 DCIS patients, 22.3% (BC) and 20.9% (DCIS) had complications. IBR decreased significantly with increased age (P < 0.00 in both cohorts), while complication rates remained stable across all ages (P = 0.32 in BC, P = 0.69 in DCIS patients). Patients were well matched in terms of demographics.
The rates of breast reconstruction decrease with increasing age. Despite increasing age, associated complication rates in IBR patients remained stable.
尽管约57%的乳腺癌（BC）诊断病例发生在老年患者（>60岁）中，但只有4.1 - 14%的患者接受乳房重建（BR）。这归因于医生对手术并发症的担忧。本文旨在：1）分析接受即刻乳房重建（IBR）的老年患者群体中的30天并发症发生率；2）分析并发症类型与重建类别之间的联系。
使用美国外科医师学会国家外科质量改进计划（ACS - NSQIP）数据库（2005 - 2014年），识别出所有年龄大于60岁且被诊断为BC和导管原位癌（DCIS）的女性。绘制所有年龄组的IBR和并发症发生率。将患者分为有并发症和无并发症两组。比较患者的人口统计学特征和合并症。分析每种重建类型中的并发症情况。
在4450例BC患者和1104例DCIS患者中，22.3%（BC）和20.9%（DCIS）发生了并发症。IBR随着年龄增长显著下降（两组均P < 0.00），而并发症发生率在所有年龄组中保持稳定（BC患者中P = 0.32，DCIS患者中P = 0.69）。患者在人口统计学特征方面匹配良好。
乳房重建率随着年龄增长而下降。尽管年龄增加，但IBR患者的相关并发症发生率保持稳定。
