title: Breast reconstruction after mastectomy for breast cancer: comparative analysis of early and delayed reconstruction.
abstract: BACKGROUND
  Early reconstruction after mastectomy for breast cancer with definitive implants has been widely used, especially with the evolution of conservative surgical breast cancer treatments. We aimed to identify different characteristics associated with plastic surgery, based on immediate or delayed reconstruction time and evaluate quality of life in patients undergoing mastectomy for cancer.
  
  
  METHODS
  This is a cross-sectional analytical study that evaluated adult patients undergoing mastectomy for breast cancer and breast reconstruction in Plastic Surgery Service at a tertiary hospital.
  
  
  RESULTS
  Between March 2011 and November 2015, 58 patients who underwent mastectomy were included, with a mean age of 51.6±10.6 years and 98.3% of them being women. Eighty percent of the patients underwent a radical mastectomy and 20% underwent segmentectomies. Immediate and delayed surgical reconstructions occurred in 22.4% and 77.6% of the cases, respectively, including immediate reconstruction with the local flap trade (15.5%), immediate reconstruction with prosthesis (6.9%), transverse rectus abdominis myocutaneous (TRAM) flap (6.9%), delayed reconstruction with local flap (8.6%), expander and prosthesis (35.7%), and reconstruction with latissimus dorsi flap and prosthesis (22.4%). When comparing subjects undergoing reconstructive surgery based on timing of reconstruction, it was observed that patients undergoing delayed breast reconstruction surgery presented a higher proportion of radical mastectomy (90.7% vs. 41.7%; P=0.001) and the need for two or more surgical interventions (64.1% vs. 20.0%; P=0.029). There was no difference in the quality of life according to reconstruction time.
  
  
  CONCLUSIONS
  The characteristics associated with postmastectomy reconstruction timing are related to preoperative factors such as the procedure employed and the number of interventions performed and have no influence on complications or the quality of life.
authors.affiliation: Plastic Surgery Unit, University Hospital Polydoro Ernani de São Thiago, Federal University of Santa Catarina, Florianópolis, Brazil - williamseidel86@gmail.com.|Postgraduate Program in Intensive and Palliative Care, Centre of Health Sciences, Federal University of Santa Catarina, Florianópolis, Brazil - williamseidel86@gmail.com.
authors.forename: William
authors.initials: W
authors.lastname: Seidel
authors.affiliation: Plastic Surgery Unit, University Hospital Polydoro Ernani de São Thiago, Federal University of Santa Catarina, Florianópolis, Brazil.
authors.forename: Jorge
authors.initials: J
authors.lastname: Bins-Ely
authors.affiliation: Plastic Surgery Unit, University Hospital Polydoro Ernani de São Thiago, Federal University of Santa Catarina, Florianópolis, Brazil.
authors.forename: Daniel
authors.initials: D
authors.lastname: Ongaratto Barazzetti
authors.affiliation: Gastroenterology and Hepatology Unit, Federal University of Santa Catarina, Florianópolis, Brazil.
authors.forename: Renata
authors.initials: R
authors.lastname: Della Giustina
authors.affiliation: Plastic Surgery Unit, University Hospital Polydoro Ernani de São Thiago, Federal University of Santa Catarina, Florianópolis, Brazil.|Postgraduate Program in Intensive and Palliative Care, Centre of Health Sciences, Federal University of Santa Catarina, Florianópolis, Brazil.
authors.forename: Gustavo P
authors.initials: GP
authors.lastname: Walter
authors.affiliation: Plastic Surgery Unit, University Hospital Polydoro Ernani de São Thiago, Federal University of Santa Catarina, Florianópolis, Brazil.|Postgraduate Program in Intensive and Palliative Care, Centre of Health Sciences, Federal University of Santa Catarina, Florianópolis, Brazil.
authors.forename: Thiago A
authors.initials: TA
authors.lastname: Ferri
authors.affiliation: Postgraduate Program in Intensive and Palliative Care, Centre of Health Sciences, Federal University of Santa Catarina, Florianópolis, Brazil.
authors.forename: Rosemeri
authors.initials: R
authors.lastname: Maurici
authors.affiliation: Postgraduate Program in Intensive and Palliative Care, Centre of Health Sciences, Federal University of Santa Catarina, Florianópolis, Brazil.|Gastroenterology and Hepatology Unit, Federal University of Santa Catarina, Florianópolis, Brazil.
authors.forename: Janaína L
authors.initials: JL
authors.lastname: Narciso-Schiavon
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000601:surgery*; D018567:Breast Neoplasms, Male / Q000601:surgery; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D016462:Mammaplasty / Q000379:methods; D008408:Mastectomy / Q000379:methods; D015412:Mastectomy, Segmental / Q000379:methods; D008875:Middle Aged; D011788:Quality of Life; D012307:Risk Factors; D013524:Surgical Flaps; D013997:Time Factors; D016896:Treatment Outcome