Immediate free flap reconstruction for XXXX : is it safe?

@entity1 @entity5 @entity0
BACKGROUND: Numerous studies have demonstrated that immediate breast reconstruction following mastectomy is associated with improvements in quality of life and body image. However, immediate breast reconstruction for @entity0 remains controversial. This study evaluates its safety in @entity1 with @entity0 . METHODS: Over a 10-year period, @entity1 diagnosed with @entity0 treated with mastectomy followed by immediate breast reconstruction were identified and analyzed. Complication rates and reconstructive aesthetics were determined. RESULTS: One hundred seventy @entity1 were identified who underwent 157 unilateral and 13 bilateral reconstructions (183 flaps) predominantly by means of free transverse rectus abdominis musculocutaneous flaps (n = 162). The average age was 47 years and the average hospital stay was 5.1 days. There were 15 major complications (8.8 percent), but adjuvant postoperative therapy was delayed in only eight @entity1 (4.7 percent), with the maximum delay lasting 3 weeks in one @entity1 . Although some degree of flap shrinkage was noted in 30 percent of @entity1 treated with postoperative radiotherapy, only 10 percent of @entity1 experienced severe breast distortion. Importantly, the overall cosmetic outcome in @entity1 who underwent postoperative irradiation was comparable to that of those who did not. CONCLUSIONS: The authors have shown that immediate breast reconstruction in the setting of @entity0 is safe and well tolerated by @entity1 , and is not associated with significant delays in adjuvant therapy. These findings make a strong argument for immediate reconstruction regardless of @entity5 stage. The authors found the changes caused by radiation to the reconstructed breast to be less significant than previously reported and readily addressed to complete an ultimate reconstruction that is aesthetically acceptable to both surgeon and @entity1 . CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.(Figure is included in full-text article.).
