A Picture of Breast Reconstruction in a Public Oncology Hospital in Latin America: A Ten-Year Experience

Abstract

Objective: Breast cancer is the most frequent malignant tumor among women worldwide, with the sole exception of non-melanoma skin cancer.Currently, one of the most common treatments in Brazil is modified radical mastectomy, which, although effective, leads to both physical and psychologicalcomplications. In this context, breast reconstruction seeks to restore the functional and psychosocial health of women. This study aims toinvestigate the characteristics of breast reconstructions after mastectomy by comparing immediate and delayed reconstructions.Materials and Methods: This is a retrospective observational study, which was performed by analyzing the electronic medical records of theErasto Gaertner Hospital in Curitiba, Brazil, from between January 2007 and December 2017.Results: After applying exclusion criteria, we analyzed a total of 268 medical records from January 2010 to December 2017. The most frequenthistological type was invasive ductal carcinoma. Patients treated after 2014 had a higher number of immediate reconstructions, and the most commonlyused method was alloplastic reconstruction using expanders (66.5%). There was no significant difference in the frequency of immediate orlate complications between patients who opted for immediate or delayed reconstructions. The most common immediate complication was surgicalwound dehiscence, and the use of neoadjuvant chemotherapy was not associated with a higher rate of complications in immediate reconstructions.Conclusion: The current preference is for immediate reconstructions with breast tissue expanders in combination with chemotherapy, which followsa trend in Brazil and worldwide that has been identified in the literature. Finally, the growth in immediate reconstructions with no associatedincrease in complications demonstrates the effectiveness of this practice.