Abstract
Introduction:
Despite recommendations by breast cancer guidelines, that immediate breast reconstruction (IBR) should be offered to all breast cancer patients considered for mastectomy national IBR rates have been reported as low as 12% in Australia. We report our oncoplastic breast cancer unit experience on acceptance of IBR, where it is routinely offered for all the medical fit breast cancer patients.
Methods:
We retrospectively reviewed, prospectively collected data on IBR by 3 oncoplastic breast cancer surgeons from 1st of September 2014 to 31st of March 2016.Patients were considered to be unfit for IBR if they were American Society of Anasthesiologist (ASA) Score 4 or 5, have unstable psychiatric illness, inflammatory breast cancer or high metastatic cancer burden. All the patients who were fit for IBR were offered both prosthetic and autologous IBR options.
Results:
137 patients underwent mastectomy operation, of whom 27 were considered unfit for IBR. Of the remaining 110 patients, 84 (76%) accepted IBR. Of the patients who had IBR 64 (76%) had single stage prosthetic, 15 (18%) two stage prosthetic and 5 (6%) autologous reconstructions. Those who accepted IBR were younger compared to those who didn't have IBR (median age: 47 yrs vs. 67 yrs, p<0.001), and were more likely to be in current relationship (78.57% vs. 61.54%, p=0.06). All the three surgeons had high IBR acceptance rates (70.45%, 71.43%, 84.44%) and patient insurance status did not influence IBR acceptance rate (public 57% vs. private 65%, p=0.47). The majority of patients (25 of 26) who did not accept IBR stated that breast reconstruction was not important for their body image.
Conclusion:
Our recent data shows, in Australia, when routinely offered to breast cancer patients who are fit for reconstructive surgery by oncoplastic breast cancer surgeons, IBR is highly accepted. Younger patients and those who are in current relationship, were more likely to accept IBR, whereas, individual perception of insignificance of breast reconstruction for the body image was the main determinant of not accepting IBR.
Citation Format: Cheung DSM, Trinh L, Edirimanne S, Eslick G. Immediate breast reconstruction is highly accepted by breast cancer patients undergoing mastectomy when routinely offered- Recent experience of an Australian tertiary oncoplastic breast unit [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-14-08.