title: Complications in immediate breast reconstruction after mastectomy.
abstract: OBJECTIVE
  Immediate post-mastectomy breast reconstruction (IBR) is a procedure that has proven advantages, but it also entails risks. The aim of this study was to identify risk factors for reconstruction failure.
  
  
  METHODS
  A review was made of all the IBR carried out at a general hospital from 2002 to 2009. Retrospective information was obtained about postoperative complications and the characteristics of patients and treatments applied. The minimum follow-up period was 9 months. Cox's regression analysis was performed on the variables related to the reconstruction failure requiring the removal of the prosthesis, with an explanatory model in which all the study variables were introduced and a predictive model that contained only the variables known before the intervention.
  
  
  RESULTS
  A total of 115 IRB interventions carried out on 112 women with breast cancer were analyzed. The mean follow-up period was 25.5 months. In sixty cases (52.2 percent), there were no complications; in sixteen cases (13.9 percent) minor complications appeared, and in 39 (33.9 percent) the complications were moderate. In twenty-six cases (22.6 percent), a reconstruction failure occurred. Cox's regression model revealed that the reconstruction failures were related to the patient's age (Hazard Ratio 1.08), to neoadjuvant chemotherapy (HR 6.24) and to postoperative tamoxifen (HR 3.10). The predictive model included the age of the patient (HR 1.05) and the use of neoadjuvant chemotherapy (HR 5.11).
  
  
  CONCLUSIONS
  A significant proportion of the patients receiving IBR developed reconstruction failure. Multivariate analysis identified three variables related to this complication, two of which were known before the intervention.
authors: Evaluation Unit, Hospital Costa del Sol and CIBER Epidemiología y Salud Pública, Marbella, Spain. ajpuente@hcs.es
authors: Alberto
authors: A
authors: Jiménez-Puente
authors: Elisa
authors: E
authors: Prieto-Lara
authors: Antonio
authors: A
authors: Rueda-Domínguez
authors: Claudio
authors: C
authors: Maañón-Di Leo
authors: Nicolás
authors: N
authors: Benítez-Parejo
authors: Francisco
authors: F
authors: Rivas-Ruiz
authors: Francisco J
authors: FJ
authors: Medina-Cano
authors: Emilio
authors: E
authors: Perea-Milla
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects* / Q000379:methods*; D015409:Mastectomy, Radical / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology*; D012189:Retrospective Studies; D013997:Time Factors