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Data show age is independently linked to increased VTE risk after breast reconstruction

Following post-mastectomy implant-based breast reconstruction, older and younger women had similar risk rates for perioperative complications; however, following autologous reconstruction, age was found to be an independent risk factor for venous thromboembolism, according to study data.

Researchers used the American College of Surgeons National Surgery Quality Improvement Program Participant Use Files to identify women with breast cancer who underwent unilateral mastectomy alone or with immediate reconstruction between 2005 and 2012. A total of 40,769 women were identified, among whom 15,093 were 65 years or older. The researchers compared 30-day complication rates between women younger than 65 years and those 65 years and older following implant-based reconstruction, autologous reconstruction or mastectomy alone.

Among women younger than 65 years, breast reconstruction was performed in 39.5% of the cases studied, whereas in women 65 years and older, reconstruction was performed in 10.7% of cases. The researchers found no significant differences between older and younger women who underwent implant-based reconstruction in the adjusted complication rates for myocardial infarction or cardiac arrest, pneumonia, renal insufficiency or failure, urinary tract infection, reoperation or transfusion rates. Additionally, rates of longer hospital stays, more frequent complications and more reoperations were similar between the groups, as well.

Conversely, women 65 years and older who underwent autologous reconstruction experienced a significantly higher rate of venous thromboembolism (VTE), according to the researchers. Specifically, the researchers established age 70 as the threshold at which patients experienced a greater increase in the odds of VTE after autologous breast reconstruction.

The researchers recommended that older women interested in autologous reconstruction should be counseled that their age may confer an increased risk of VTE, and special attention should be given to this risk factor within this older patient population. – by Abigail Sutton

Disclosures: The authors report no relevant financial disclosures.