The impact of axillary node surgery on outcomes following immediate breast reconstruction

Autor:	Albert Losken, Alexandra M. Hart, Kirsten M Baecher, Toncred M. Styblo, Grant W. Carlson, Nusaiba Baker
Rok vydání:	2020
Předmět:	medicine.medical_specialty medicine.medical_treatment Mammaplasty Sentinel lymph node Breast Neoplasms 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Internal Medicine medicine Humans Lymph node Mastectomy Neoplasm Staging Retrospective Studies business.industry Sentinel Lymph Node Biopsy Axillary Lymph Node Dissection Retrospective cohort study medicine.disease Surgery medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Seroma Axilla Lymph Node Excision Lymphadenectomy Female Lymph Nodes business Breast reconstruction
Zdroj:	The breast journalREFERENCES. 26(11)
ISSN:	1524-4741
Popis:	Immediate breast reconstruction (IBR) has become the most common method for postmastectomy reconstruction. Axillary lymph node dissection is performed for the staging of patients, but the impact of IBR with nodal surgery on postoperative complications remains elusive. The present study aims to investigate the impact of concomitant axillary lymph node surgery on postoperative complications. We conducted a retrospective study of patients who underwent IBR from 2000 to 2014. We recorded and analyzed patient data to determine the association between nodal surgery and postsurgical complications. Univariate and multivariate analyses were utilized to elucidate the risk of a complication given nodal surgery, sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND), and type of incision for nodal access. A total of 986 breast reconstructions were included for analysis. Overall incidence of postoperative complications per breast that received nodal surgery was 35.9% (n = 230/642), compared to 25.6% (n = 88/344) in breasts that did not have concomitant nodal surgery (P = .001). Nodal surgery was found to increase risk of all complications with an odds ratio of 1.62 (P = .001). Moreover, complications were significantly higher in patients whose nodes were accessed via mastectomy incision (39.4%) when compared to a separate incision (33.5%). Multivariate analysis showed that nodal sampling through the mastectomy incision is a significant risk factor for seroma, with an odds ratio of 3.60 (P = .002). We did not observe differences in breast complications in patients who underwent SLNB vs ALND. These factors should be taken into account in the approach to breast reconstruction during lymphadenectomy.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a01a4a0ec5640700f0df5b318f2ec295 https://pubmed.ncbi.nlm.nih.gov/33051937 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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