Complications after breast reconstruction tied to worse survival, recurrence

Postoperative complications that occur following total mastectomy and immediate reconstruction in breast cancer patients can be a tell-tale sign of poor survival and recurrence, suggests a study.

“Immediate breast reconstruction is safe from an oncological perspective, but the relatively high rate of postoperative complications raises oncological concerns,” the authors said.

To assess the potential impact of postoperative complications on recurrence and survival, patients with breast cancer who had total mastectomy and immediate reconstruction between 2008 and 2013 were followed for at least 5 years. Multivariable Cox regression analyses were performed to examine the influence of postoperative complications on oncological outcomes.

A total of 483 patients with a median follow-up of 82 months were included in the analysis. The corresponding 5-year local recurrence-free, disease-free, and overall survival rates were 95.4 percent, 93.1 percent, and 98.4 percent.

One hundred twenty patients (27.4 percent percent) developed postoperative complications in the operated breast and 30 patients (6.8 percent) at other sites (flap donor). Development of breast complications led to a significant increase in the rate of recurrence as compared with no complications (16.7 percent vs 5.9 percent; p=0.002).

Multivariate analysis revealed a significantly worse disease-free survival among patients with breast complications compared to those with no complications (hazard ratio [HR], 2.25; p=0.015). The significant association between postoperative complications and poor survival persisted in patients who received adjuvant chemotherapy without delay (≤8 weeks after surgery; HR, 2.45; p=0.034).