Maisel Lotan Adi, Teldan Yotam, Toledano Ronen, Talisman Shahar, Strano Shalom, Goldvaser Hadar, Zobok Tal, Gronovich Yoav
From the Department of Plastic and Reconstructive Surgery, Shaare Zedek Medical Center, Jerusalem, Israel.
Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Plast Reconstr Surg Glob Open. 2025 Mar 25;13(3):e6647. doi: 10.1097/GOX.0000000000006647. eCollection 2025 Mar.
Immediate breast reconstruction following mastectomy has many proven advantages. Although more than half of the patients with breast cancer in the United States are older than 65 years of age, breast reconstruction rates in this age group are low. The goal of this study was to evaluate safety and patient satisfaction of direct-to-implant (DTI) prepectoral breast reconstruction in women older than 65 years of age.
This was a retrospective, single-center study of 56 women (56 breasts) undergoing DTI prepectoral breast reconstruction. Twenty-eight patients were older than the age of 65 years and 28 were younger. Groups were matched for surgical procedure, smoking status, body mass index, and history of radiation therapy. Outcomes were compared between groups, and possible correlations were studied.
Twelve patients older than 65 years of age had hypertension ( = 0.007). Perioperative pain management, major complications, total number of surgical complications, reconstruction failure, and duration of hospitalization were similar in both groups. More advanced age was correlated with higher psychosocial well-being, sexual well-being and satisfaction with breasts on the BREAST-Q scale. Median follow-up was 11.5 months (older) and 23 months (younger).
Prepectoral DTI breast reconstruction in women older than 65 years of age is safe, reproducible, has high patient satisfaction, and may be performed in this patient cohort.
乳房切除术后即刻乳房重建有许多已被证实的优点。尽管美国超过一半的乳腺癌患者年龄超过65岁，但该年龄组的乳房重建率较低。本研究的目的是评估65岁以上女性直接植入式（DTI）胸肌前乳房重建的安全性和患者满意度。
这是一项对56名接受DTI胸肌前乳房重建的女性（56个乳房）进行的回顾性单中心研究。28名患者年龄超过65岁，28名患者年龄较小。两组在手术方式、吸烟状况、体重指数和放疗史方面进行匹配。比较两组的结果，并研究可能的相关性。
12名65岁以上的患者患有高血压（P = 0.007）。两组在围手术期疼痛管理、主要并发症、手术并发症总数、重建失败和住院时间方面相似。在BREAST-Q量表上，年龄越大，心理幸福感、性幸福感和对乳房的满意度越高。中位随访时间为11.5个月（年龄较大者）和23个月（年龄较小者）。
65岁以上女性胸肌前DTI乳房重建是安全的、可重复的，患者满意度高，可在该患者队列中进行。
