Effect of Patient Age on Outcomes in Breast Reconstruction: Results from a Multicenter Prospective Study.
Although >40% of new breast cancer diagnoses in the US are in older women, few studies have assessed the outcomes of post-mastectomy reconstruction in this population. Our objective was to evaluate age effects on postoperative complications and patient-reported outcomes in women undergoing breast reconstruction, and to investigate whether age effects differ between reconstructive procedure types.



Eligible patients in the Mastectomy Reconstruction Outcomes Consortium study from 11 institutions (57 providers) in North America were analyzed. Two-year complications and patient-reported outcomes via BREAST-Q domains were compared across younger (younger than 45 years), middle-aged (45 to 60 years), and older (older than 60 years) women. Mixed-effects regression models were used, controlling for a range of demographic and clinical covariates.



A total of 1,531 patients were studied: 494 younger, 803 middle-aged, and 234 older. Age was not a significant predictor of complications. For sexual well-being 2 years post-reconstruction, older women reported 4.25 (p = 0.04) higher mean scores with implant procedures, and 10.39 (p < 0.01) higher mean scores with autologous procedures compared with younger women. No age effect was seen with implant procedures with regard to physical and psychosocial well-being; however, older women who underwent autologous procedures reported 6.07 (p < 0.01) higher physical, and 8.21 (p < 0.01) higher psychosocial well-being scores than younger women.



Age did not significantly affect complication rates. Older women demonstrated higher sexual well-being for both procedures, and better satisfaction and physical and psychosocial well-being than younger women with autologous procedures. Post-mastectomy reconstruction is a viable option for older patients, with risks and benefits comparable with those in younger women.
Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI.
Katherine B
KB
Santosa
Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI.
Ji
J
Qi
Center for Statistical Consultation and Research, Department of Biostatistics, University of Michigan, Ann Arbor, MI.
Hyungjin M
HM
Kim
Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI.
Jennifer B
JB
Hamill
Department of Plastic and Reconstructive Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York.
Andrea L
AL
Pusic
Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI. Electronic address: ewilkins@med.umich.edu.
Edwin G
EG
Wilkins
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D011446:Prospective Studies; D012737:Sex Factors