Greater Risk in Double vs. Single Mastectomy
But the complication rate associated with breast cancer surgery and reconstruction is small.
Women with breast cancer who have a double mastectomy are at higher risk of certain complications than those who have a single mastectomy, according to research scheduled to be presented at the American Society of Clinical Oncology's 2014 Breast Cancer Symposium, held from Sept. 4 to 6 in San Francisco.
Amanda Silva, M.D., of the University of Chicago Pritzker School of Medicine, and colleagues analyzed data for 18,229 women who underwent mastectomy with breast reconstruction, typically implant-based, including 6,502 women (35.7 percent) who underwent bilateral mastectomy. The authors examined differences in perioperative complications for bilateral versus unilateral mastectomy with breast reconstruction.
The researchers found that for implant-based reconstruction, those who underwent bilateral versus unilateral mastectomy had higher rates of implant loss (adjusted odds ratio [aOR], 1.55; P = 0.02), transfusion (aOR, 2.20; P < 0.001), and reoperation (aOR, 1.14; P = 0.05). For autologous reconstruction, those who underwent bilateral versus unilateral mastectomy had higher rates of transfusion (aOR, 2.34; P < 0.001).
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For implant-based and autologous reconstruction, those who underwent bilateral versus unilateral mastectomy were more likely to have a hospital stay of two days or longer (aOR, 2.22 and 2.25, respectively; P < 0.001). No differences were observed between the groups (for either type of reconstruction) in rates of medical complications, surgical site infection, or wound disruption.
"Our findings show that both unilateral and bilateral procedures are safe overall, but bilateral mastectomy is associated with higher risks for certain complications," a coauthor said in a statement.
One author disclosed financial ties to the biomedical industry.
- Silva, Amanda Kathryn, et al. "A NSQIP analysis of 30-day complications after bilateral versus unilateral mastectomy with immediate reconstruction." ASCO 2014 Breast Cancer Symposium Meeting Abstracts. J Clin Oncol 32, 2014 (suppl 26; abstr 62). September 4, 2014.