title: Immediate breast reconstruction following mastectomy in pregnant women with breast cancer.
abstract: BACKGROUND
  Surgical management of breast cancer in pregnancy (BCP) requires balancing benefits of therapy with potential risks to the developing fetus. Minimal data describe outcomes after mastectomy with immediate breast reconstruction (IR) in pregnant patients.
  
  
  METHODS
  Retrospective review was performed of patients who underwent IR after mastectomy within a BCP cohort. Parameters included intra- and post-operative complications, short-term maternal/fetal outcomes, surgery duration, and delayed reconstruction in non-IR cohort.
  
  
  RESULTS
  Of 82 patients with BCP, 29 (35%) had mastectomy during pregnancy: 10 (34%) had IR, 19(66%) did not. All IR utilized tissue expander (TE) placement. Mean gestational age (GA) at IR was 16.2 weeks. Mean surgery duration was 198 min with IR versus 157 min without IR. Those with IR delivered at, or close to, term infants of normal birthweight. No fetal or major obstetrical complications were seen. Post-mastectomy radiation (PMRT) was provided after pregnancy in 2 (20%) patients in the IR cohort and 12 (63%) in the non-IR cohort. All patients in the IR cohort successfully transitioned to permanent implant.
  
  
  CONCLUSIONS
  This report represents one of the largest series describing IR during BCP. IR after mastectomy increased surgery duration, but was not associated with adverse obstetrical or fetal outcomes. IR with TE may preserve reconstructive options when PMRT is indicated. J. Surg. Oncol. 2016;114:140-143. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts.
authors.forename: Diana L
authors.initials: DL
authors.lastname: Caragacianu
authors.affiliation: Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts.
authors.forename: Erica L
authors.initials: EL
authors.lastname: Mayer
authors.affiliation: Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Yoon S
authors.initials: YS
authors.lastname: Chun
authors.affiliation: Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Caterson
authors.affiliation: Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts.
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Bellon
authors.affiliation: Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts.
authors.forename: Julia S
authors.initials: JS
authors.lastname: Wong
authors.affiliation: Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts.
authors.forename: Susan
authors.initials: S
authors.lastname: Troyan
authors.affiliation: Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts.
authors.forename: Esther
authors.initials: E
authors.lastname: Rhei
authors.affiliation: Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts.
authors.forename: Laura S
authors.initials: LS
authors.lastname: Dominici
authors.affiliation: Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Economy
authors.affiliation: Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Nadine M
authors.initials: NM
authors.lastname: Tung
authors.affiliation: Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Lidia
authors.initials: L
authors.lastname: Schapira
authors.affiliation: Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts.
authors.forename: Ann
authors.initials: A
authors.lastname: Partridge
authors.affiliation: Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts.
authors.forename: Katherina Zabicki
authors.initials: KZ
authors.lastname: Calvillo
mesh_terms: D000328:Adult; D018427:Breast Implants; D001943:Breast Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D016462:Mammaplasty; D008408:Mastectomy; D011183:Postoperative Complications; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: fetal outcomes; malignancy; multidisciplinary care; pregnancy; reconstructive surgery