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Post-Mastectomy Reconstruction Feasible for Older Women

For older women, breast reconstruction after mastectomy is safe and well tolerated

FRIDAY, Dec. 9 (HealthDay News) -- Breast reconstruction after mastectomy is safe, feasible, and well tolerated in older women, according to a study published in the December issue of The American Surgeon.

Marissa Howard-McNatt, M.D., from the Wake Forest University Baptist Medical Center in Winston-Salem, N.C., and colleagues reviewed their experience in breast reconstruction after mastectomy in older women. A total of 89 women (mean age, 65 years) who underwent mastectomy and reconstruction from January 1998 to June 2008 were evaluated through retrospective chart review.

The investigators found that 41 percent of women had stage 1 breast cancer, 30 percent had stage 2, 25 percent had ductal carcinoma in situ, and 2 percent had stage 3 disease. Mastectomy was performed in 11 percent of women for ipsilateral breast tumor recurrence after radiation therapy and lumpectomy. The majority of women (89 percent) underwent immediate breast reconstruction. Two-stage implant, transverse rectus abdominus musculocutaneous (TRAM) flap, latissimus dorsi musculocutaneous flap with implant, or deep inferior epigastric perforator flap techniques of breast reconstruction were used in 58, 10, 2, and 1 percent of women, respectively. Complications included removal of two expanders due to exposure, one TRAM failure, one TRAM debridement, and a 12 percent infection rate. Of the four mastectomies with tissue expanders, one expander was removed due to radiation. The implant was removed and skin resected in one local skin recurrence. Two patients died from metastatic disease.

"Breast cancer reconstruction in older women is a feasible option that should be offered to patients," the authors write.

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