Age Is Not a Risk Factor for Post-Mastectomy Reconstructive Surgery

Long-term follow-up of women who underwent mastectomy and breast reconstruction subsequent to a breast cancer diagnosis found that the success of the procedure and associated complications were not influenced by the woman’s age.

The authors of the study followed 1531 women across 11 institutions in the United States and Canada, as part of the Mastectomy Reconstruction Outcomes Consortium study. The 2-year follow-up aimed to evaluate age effects on postoperative complications and patient-reported outcomes. The study population included 494 younger women (less than 45 years), 803 middle-aged women (45-60 years), and 234 older women (more than 60 years).

Although previous studies had tried to address this question, they were flawed according to lead study author Edwin Wilkins, MD, FACS, professor of surgery in the section of plastic surgery, University of Michigan.

“Most previous studies provided just a snap-shot in time. They looked retrospectively at the previous 10 years, identified patients who had breast reconstruction, and then studied them,” Wilkins said in a statement. “This study started before the patients had reconstruction and followed them for 2 years afterward. It essentially studied all patients over the same interval. It provided a baseline measurement of body image, quality of life, and overall health because where a patient is before surgery has a large effect on where she ends up 2 years later,” he emphasized.

The authors of the study documented overall rates of any type of complication as well as major complications that would need hospital readmission or a repeat surgery. Patient-reported outcomes were documented using the BREAST-Q Reconstructive Module. The researchers observed that complication rates varied based on the type of procedure—complication rates with surgical implant increased from 22% among younger women to 29% in the older group. Rates for a major complication, however, did not vary much by age. For sexual well-being, older women reported 4.25 (P = .04) higher mean scores with implant procedures, and 10.39 (P <.01) higher mean scores with autologous procedures compared with younger women. Also, older women who had autologous procedures reported 6.07 (P <.01) higher physical, and 8.21 (P <.01) higher psychosocial well-being scores than younger women.

“Surgeons and patients may have preconceived notions that breast reconstruction is not as good an option in older women as it is in younger patients,” Wilkins said. "According to findings from this study, reconstruction provided the benefits it was expected to provide for quality of life and body image, and age did not significantly affect complications."

Reference

Santosa KB, Qi J, Kim HM, et al. Effect of patient age on outcomes in breast reconstruction: results from a multicenter prospective study [published online October 26, 2016]. J Am Coll Surg. doi: http://dx.doi.org/10.1016/j.jamcollsurg.2016.09.003.