title: Short-term outcomes of immediate breast reconstruction using an implant or tissue expander after mastectomy in breast cancer patients.
abstract: BACKGROUND
  Mastectomy is an optional surgical management of breast cancer, but it can cause significant adverse reactions. Breast reconstruction is a concern in post-mastectomy recovery. We assessed the oncologic safety and patient satisfaction following immediate breast reconstruction using an implant or tissue expander.
  
  
  METHODS
  We retrospectively reviewed all patients who underwent reconstruction with an implant or tissue expander immediately after mastectomy. Seventy-seven patients underwent breast reconstruction at a general hospital breast cancer center from January 2008 to December 2010. Fourteen patients were excluded due to loss at follow-up, so 63 patients were included in this study. Questionnaires were sent to all patients to assess patient satisfaction.
  
  
  RESULTS
  Mean age was 44.1 years (range 29-64). After a median follow-up period of 22.4 months, there was 1 case of locoregional recurrence, 1 case of distant metastasis, and an overall breast cancer-specific survival of 100 %. Overall rate of major complications, such as nipple areolar complex (NAC) necrosis and implant removal, was 11.1 % (7 patients). Of the 10 patients who had NAC necrosis, 6 patients improved after observation and 4 patients had NAC excision. Three patients had their implant removed due to severe infection, leakage, and dissatisfaction, respectively. There were 32 cases of total mastectomy (TM), 12 cases of skin-sparing mastectomy (SSM), and 19 cases of NAC-sparing mastectomy (NSM). According to the questionnaire, 84.1 % were satisfied with the general operational result and 77.8 % with the cosmetic result. Of the 31 patients who received conservative surgery, 87.1 % were satisfied with the general result and 83.9 % with the cosmetic result.
  
  
  CONCLUSIONS
  Immediate breast reconstruction using an implant after mastectomy was technically feasible and oncologically safe. In addition, the reconstruction resulted in a relatively high rate of patient satisfaction. Further long-term studies are warranted to confirm these findings.
authors.affiliation: Department of General Surgery, Catholic Kwandong University College of Medicine, Cheil General Hospital, 1-19 Mukjeong-dong, Jung-gu, Seoul, 100-380, Korea.
authors.forename: Se Won
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of General Surgery, Catholic Kwandong University College of Medicine, Cheil General Hospital, 1-19 Mukjeong-dong, Jung-gu, Seoul, 100-380, Korea. haelee67@kebi.com.
authors.forename: Hae Kyung
authors.initials: HK
authors.lastname: Lee
authors.affiliation: Department of General Surgery, Catholic Kwandong University College of Medicine, Cheil General Hospital, 1-19 Mukjeong-dong, Jung-gu, Seoul, 100-380, Korea.
authors.forename: Sun Mi
authors.initials: SM
authors.lastname: Kang
authors.affiliation: Department of General Surgery, Catholic Kwandong University College of Medicine, Cheil General Hospital, 1-19 Mukjeong-dong, Jung-gu, Seoul, 100-380, Korea.
authors.forename: Tae Ho
authors.initials: TH
authors.lastname: Kang
authors.affiliation: Department of General Surgery, Catholic Kwandong University College of Medicine, Cheil General Hospital, 1-19 Mukjeong-dong, Jung-gu, Seoul, 100-380, Korea.
authors.forename: Chan Seok
authors.initials: CS
authors.lastname: Yoon
authors.affiliation: Department of General Surgery, Catholic Kwandong University College of Medicine, Cheil General Hospital, 1-19 Mukjeong-dong, Jung-gu, Seoul, 100-380, Korea.
authors.forename: Seung Sang
authors.initials: SS
authors.lastname: Ko
authors.affiliation: Department of General Surgery, Catholic Kwandong University College of Medicine, Cheil General Hospital, 1-19 Mukjeong-dong, Jung-gu, Seoul, 100-380, Korea.
authors.forename: Min Hee
authors.initials: MH
authors.lastname: Hur
authors.affiliation: Department of General Surgery, Catholic Kwandong University College of Medicine, Cheil General Hospital, 1-19 Mukjeong-dong, Jung-gu, Seoul, 100-380, Korea.
authors.forename: Sung Soo
authors.initials: SS
authors.lastname: Kang
authors.affiliation: JW Plastic Surgery, Seoul, Korea.
authors.forename: Chul Hwan
authors.initials: CH
authors.lastname: Seul
authors.affiliation: Department of Nursing, Graduate School of Kyung Hee University, Seoul, Korea.
authors.forename: Ja Sung
authors.initials: JS
authors.lastname: Gu
mesh_terms: D000328:Adult; D018427:Breast Implants; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000473:pathology* / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology* / Q000601:surgery; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D017060:Patient Satisfaction; D011379:Prognosis; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D015625:Tissue Expansion Devices
keywords: Breast cancer; Immediate breast reconstruction; Implant; Mastectomy; Tissue expander