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What Factors Affect Breast Reconstruction Techniques?

May 7th 2012 at 11:06 PM

Patients who have gone through mastectomy (the surgical removal of the breast) usually go through a process of breast reconstruction to surgically rebuild breast tissue. Breast reconstruction involves the use of prosthetic material or autologous tissue to create a natural-looking and natural-feeling breast. Then, what are the techniques commonly used for breast construction and what factors affect these techniques?

According to a recent study published in the Plastic and Reconstructive Surgery May issue, breast reconstruction techniques are influenced by several hospital- and patient-related factors. In fact, current decisions for breast reconstruction are not based exclusively on anatomic features or patient preferences.

Under the study, headed by Dr. C.R. Albornoz, who practices in the Memorial-Sloan-Kettering Cancer Center in New York, the researchers used a huge hospital database to evaluate information on about 16,000 women that had gone through mastectomy in the US in 2008. About 6,000 patients went through immediate breast reconstruction, with the total reconstruction rate at around 38 percent. Meanwhile, another 1,300 patients went through delayed reconstruction. Delayed reconstructions are usually performed to reduce the risk among patients with medical comorbidities like diabetes, obesity and high blood pressure.

According to the study, the most common reconstruction method was breast implant, used by 60.5 percent of women. Thirty-four percent of breast reconstructions were performed with traditional plastic surgery skin flaps, while 5.5 percent used advanced microsurgical flap methods. With the microsurgical and conventional flap methods, the patients’ own tissues are used to reconstruct the breast, a process called autologous reconstruction.

The study listed race and age as some of the factors that influenced the choice of breast reconstruction methods. It found that breast implants were more common to younger patients, and to Asian or Caucasian patients than Hispanic or African American women. Implants were also more likely for higher income patients and in US regions except the Northeast.

Autologous reconstruction was more common for patients in their 50s and those being treated at teaching hospitals, as well as patients with private insurance, the study said. Microsurgical breast reconstruction methods, on the other hand, were more common in patients with private insurance and at teaching hospitals. They were also more often used for delayed reconstruction than immediate reconstruction methods.

Microsurgical methods have some key advantages compared to other breast reconstruction techniques, providing new options for using the own tissues of patients for reconstruction, said the study. They also give outstanding results and avoid discomfort and some of the side effects of traditional flap methods.

Though the overall breast reconstruction rate has improved, microsurgical methods still comprise a small percentage or reconstructions, the researchers wrote. They added that only a small proportion of hospitals and surgeons could now offer microsurgical breast reconstruction as reflected by the effect of teaching hospital status.

The findings of the study imply that the decision making when it comes to breast reconstruction is influenced by some hospital- and patient-related factors like the hospital where the patient is treated and the demographic characteristics of patients. With this knowledge, the researchers concluded that initiatives should be done to minimize gaps so that breast construction methods are based exclusively on patient’s preference and anatomic considerations.


NOTE : This Article is originally posted by plasticsurgeryblog.

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