A Propensity-Matched Analysis of the Influence of Breast Reconstruction on Subsequent Development of XXXX .

@entity1 @entity101 @entity0 @entity28 @entity5 @entity4269 @entity86 @entity65
BACKGROUND: Recent literature demonstrates a lower incidence of @entity4269 with breast reconstruction. This study compared the incidence of @entity4269 after axillary dissection in a propensity-matched cohort of @entity1 with and without immediate breast reconstruction. METHODS: A review of @entity1 undergoing axillary lymphadenectomy with or without immediate breast reconstruction from January 1, 2000, to July 1, 2013, was conducted. Comorbidities, @entity5 treatment, operative characteristics, and pathologic findings were reviewed. The primary outcome was @entity86 . Univariate analysis identified baseline differences between the @entity1 groups. Cohorts were propensity-matched by age, body mass index greater than 30 kg/m, adjuvant radiation therapy, @entity65 , and @entity101 . Subsequent multivariate regression was performed to identify independent predictors of @entity4269 among matched @entity1 . RESULTS: A total of 4647 @entity1 underwent @entity0 resection, with 1955 having axillary lymphadenectomy (no reconstruction, n = 1200; autologous, n = 563; implant-based, n = 192). Matching yielded a cohort of 239 reconstruction and 239 no-reconstruction @entity1 demonstrating no differences in age, body mass index, @entity101 , adjuvant radiation therapy, or axillary dissection extent. With 55.9 months' follow-up, @entity86 was diagnosed in 94 @entity1 (19.7 percent). Reconstruction @entity1 developed @entity4269 in 19.2 percent of cases versus 20.1 percent for no- reconstruction @entity1 (p = 0.82). Regression identified two independent predictors of @entity4269 : postoperative radiation therapy (OR, 2.90; p < 0.001) and @entity28 (OR, 2.36; p < 0.001). CONCLUSIONS: This study demonstrates a 19.7 percent incidence of @entity4269 following axillary lymphadenectomy. Reconstruction does not appear to alter @entity4269 risk, whereas postoperative radiation therapy, @entity28 , and extensive axillary dissection greatly increase risk. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
