title: Breast reconstruction in women under 30: a 10-year experience.
abstract: The number of women diagnosed with breast cancer at a young age (≤30years) continues to rise. As young women present for breast cancer management with greater frequency, an accurate characterization of the differences in cancer treatments and reconstruction techniques is imperative to optimize care. Here, we sought to identify the reconstruction trends in this population of women ≤30years at time of breast cancer diagnosis. We retrospectively reviewed the charts of women aged ≤30years who underwent breast reconstruction at The University of Texas M.D. Anderson Cancer Center. We extracted data on the patients' diagnosis, adjuvant therapy, reconstructive choice, reason for reconstructive choice, and decision for contralateral prophylactic mastectomy (CPM). Over a 10-year period, 54 patients aged ≤30years underwent 77 breast reconstructions, including 30 microsurgical autologous tissue reconstructions and 34 tissue expander-based reconstructions. Donor site limitations, including insufficient abdominal tissue, restricted the number of patients eligible for abdominal based reconstruction despite the patients' interest in the latter. The rate of CPM was 43%, which was significantly higher than the national average of 8%, further complicating the possibility of total autologous reconstruction. Because of the high rate of bilateral mastectomy and innate donor tissue limitations, young, healthy women who are otherwise ideal candidates for free tissue transfer using the abdominal donor site undergo significantly more tissue expander reconstructions than expected. Implant-based reconstruction or donor sites other than the abdomen must be considered in this unique population.
authors.affiliation: Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Clinical Care Center, Houston, Texas, USA.
authors.forename: Warren A
authors.initials: WA
authors.lastname: Ellsworth
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Bass
authors.forename: Roman J
authors.initials: RJ
authors.lastname: Skoracki
authors.forename: Lior
authors.initials: L
authors.lastname: Heller
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D018427:Breast Implants; D001943:Breast Neoplasms / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D005260:Female; D058752:Free Tissue Flaps; D006801:Humans; D016462:Mammaplasty / Q000379:methods* / Q000706:statistics & numerical data; D008408:Mastectomy / Q000706:statistics & numerical data; D057240:Patient Preference; D011183:Postoperative Complications; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D013997:Time Factors; D015626:Tissue Expansion; D014182:Transplantation, Autologous