title: Advanced Age Does Not Worsen Recovery or Long-Term Morbidity After Postmastectomy Breast Reconstruction.
abstract: OBJECTIVE
  Despite evidence that older women have quality-of-life outcomes similar to younger women after postmastectomy breast reconstruction (PMBR), they rarely receive it. There is a perception that PMBR in older women may result in significant physical morbidity. However, the effects of age on physical morbidity after PMBR have not been studied. This study sought to assess perceptions of recovery from surgery and long-term chest and upper body morbidity in older women who receive PMBR.
  
  
  METHODS
  Women with American Joint Committee on Cancer stage 0-III breast cancer who underwent a mastectomy with PMBR between 2005 and 2011 were surveyed to assess their functional health status (DUKE), physical well-being (BREAST-Q), and perceptions of recovery from surgery. Patients were stratified into 2 age groups: older (≥65 years) and younger (<65 years). Outcome scores were compared by mastectomy laterality, reconstruction type, and between age groups. Data were analyzed using χ² and t tests.
  
  
  RESULTS
  One hundred eight older and 103 younger patients returned surveys (response rate, 75.4%). The median time from mastectomy to survey was 4 years (range, 1-7). Younger women were more likely to undergo bilateral mastectomy than older women (65.7% vs 32.2%, P < 0.001). Some women (66.9%) underwent implant-only reconstruction and 33.1% underwent autologous reconstruction; there were no significant differences in reconstruction type between age groups. Patients who underwent unilateral and bilateral mastectomy had similar mean BREAST-Q physical well-being scores (79.4 vs 78.9, respectively, P = 0.85). There was no difference in mean physical well-being scores between older and younger patients (80.0 vs 78.5, respectively, P = 0.61). In addition, older patients were less likely to perceive their recovery from PMBR as being difficult than younger patients, though this was not statistically significant (48.2% vs 64.3%, P = 0.07).
  
  
  CONCLUSIONS
  Older women who undergo PMBR have physical and upper body well-being that is similar to younger women. In addition, their perception of recovery from PMBR is at least as good as that seen in younger women. Older women contemplating PMBR should be counseled that they are not at higher risk for long-term physical and upper body morbidity from PMBR than are younger women.
authors.affiliation: From the *Division of Plastic Surgery, Department of Surgery, †Center for Biomedical Research Informatics, Department of Surgery, NorthShore University HealthSystem, Evanston, IL; ‡University of Chicago Pritzker School of Medicine, Chicago, IL; and §The Joint Commission, Oakbrook Terrace, IL.
authors.forename: Donald B
authors.initials: DB
authors.lastname: Johnson
authors.forename: Brittany
authors.initials: B
authors.lastname: Lapin
authors.forename: Chihsiung
authors.initials: C
authors.lastname: Wang
authors.forename: Katharine
authors.initials: K
authors.lastname: Yao
authors.forename: Kenneth
authors.initials: K
authors.lastname: Rasinski
authors.forename: Veronica
authors.initials: V
authors.lastname: Rundell
authors.forename: Mark
authors.initials: M
authors.lastname: Sisco
mesh_terms: D000368:Aged; D019928:Breast Implantation / Q000706:statistics & numerical data*; D018427:Breast Implants / Q000009:adverse effects / Q000706:statistics & numerical data*; D001943:Breast Neoplasms / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology*; D013997:Time Factors; D014481:United States