Recent developments in breast surgery

Recent developments reported on Healio.com/Aesthetics have included study results finding a greater risk for skin flap necrosis and implant failure in direct-to-implant breast reconstruction compared with two-stage tissue expander/implant reconstruction.

Other developments included findings that mastectomy with breast reconstruction led to a nearly twofold increased risk for complications as well as higher cost compared with other surgical options for younger and older women with early breast cancer:

Implant failure risk greater in direct-to-implant vs two-stage breast reconstruction

There was a greater risk for skin flap necrosis and implant failure in direct-to-implant breast reconstruction compared with two-stage tissue expander/implant reconstruction, according to study results.

Researchers conducted a literature search for articles published after 1999 involving a two-stage tissue expander/implant or using a direct-to-implant technique for prosthetic-based breast reconstruction. Read more

Abdominal-based autologous breast reconstruction may lead to surgically treated hernia

Surgically repaired abdominal hernias were not uncommon in women who underwent abdominal-based autologous breast reconstruction, according to recent data.

Researchers identified 8,246 women who underwent pedicled transverse rectus abdominis muscle (TRAM; 29.9%), free TRAM (30%), or deep inferior epigastric perforator (DIEP; 40.8%) flap breast reconstruction from 2008 to 2012 by using inpatient and ambulatory surgery data from California, Florida, Nebraska and New York. Read more

Reconstruction after mastectomy increases complication rates, cost

SAN ANTONIO — Mastectomy with breast reconstruction led to a nearly twofold increased risk for complications as well as higher cost compared with other surgical options for younger and older women with early breast cancer, according to research presented by Benjamin D. Smith, MD, and colleagues.

Benjamin D. Smith

Available local treatment options for women diagnosed with early breast cancer in the U.S. include lumpectomy alone or with whole-breast irradiation or brachytherapy, or mastectomy alone or with breast reconstruction. With Perspective. Read more

Prophylactic mastectomy may be cost effective compared with surveillance

Contralateral or bilateral prophylactic mastectomy may be cost saving in lifetime third-party costs for patients recently diagnosed with unilateral breast cancer and for BRCA gene carriers, according to study results.

Researchers used 2013 Medicare reimbursement rates to estimate lifetime third party payer costs over 30 years. They estimated costs for patients recently diagnosed with unilateral breast cancer choosing contralateral prophylactic mastectomy, and for BRCA gene carriers choosing bilateral prophylactic mastectomy vs. surveillance. Read more