Bilateral risk-reducing mastectomies with implant-based reconstructions followed long term: a consecutive series of 185 patients

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Isaksson, Karin (author)

Bilateral risk-reducing mastectomies with implant-based reconstructions followed long term : a consecutive series of 185 patients

Article/chapterEnglish2019

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2019-05-22
Springer Science and Business Media LLC,2019
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LIBRIS-ID:oai:DiVA.org:shh-3368
https://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-3368URI
https://doi.org/10.1007/s00268-019-05037-4DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:141523254URI

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Language:English
Summary in:English

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SwePubSwePub

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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BACKGROUND: Bilateral risk-reducing mastectomy (BRRM) is the most effective method to prevent breast cancer in genetically predisposed women and is often performed concomitantly with breast reconstruction. The reconstruction time varies and corrective surgeries are common.METHODS: This study evaluated 185 consecutive cases of BRRM and immediate breast reconstruction with implants with regard to surgical outcome and resource consumption. With an 18-year observation period, it was possible to compare permanent expander implants (PEIs) with permanent fixed volume implants (PIs).RESULTS: A minimum follow-up of 2 years for all participants but one was achieved. Seventy-five percent (n = 138) of the women received PEI and 25% (n = 47) PI. In a multivariate analysis including age, BMI (<25, ≥25), smoking (yes, no), implant type (PEI, PI), incision technique, operation time and specimen weight <350 g, ≥350 g), only BMI ≥25 was associated with an increased risk of an early complication (OR 7.1, 95% CI 2.44-20.4). As expected, there was a significant difference in median reconstruction time between PEI and PI (12.4 vs. 1.0 months, p < 0.001). The cumulative reoperation-free 2-year survival was significantly higher in the PI than in the PEI group (81% vs. 26%, p < 0.001).CONCLUSION: Implant-based reconstruction remains a valid option after BRRM in high-risk women. Whenever possible (low BMI and small breast volume without severe ptosis), permanent fixed volume implants can be safely recommended and are resource saving in comparison with permanent expander implants.

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MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng

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Arver, Brita (author)
Bottai, MatteoKarolinska Institutet (author)
Pettersson, AndreasKarolinska Institutet (author)
Wickman, MarieKarolinska Institutet,Sophiahemmet Högskola(Swepub:shh)marie.wickman (author)
Sandelin, KerstinKarolinska Institutet (author)
Sophiahemmet HögskolaKarolinska Institutet (creator_code:org_t)

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In:World Journal of Surgery: Springer Science and Business Media LLC43:9, s. 2262-22700364-23131432-2323

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By the author/editor: Isaksson, Karin; Arver, Brita; Bottai, Matteo; Pettersson, Andr ...; Wickman, Marie; Sandelin, Kersti ...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Surgery

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